The Racist Roots of the BMI Measure is Harming Black Women

I am a big and tall woman and according to my BMI, my healthy weight should be what I would consider to be a ludicrous amount. I cannot possibly maintain that weight on my height, bone structure and muscle mass. The Body Mass Index (BMI) is a measure of body fat based on height and weight that applies to adult men and women, but it was not developed for or tested on people of color or women, both of which I am. Historically, the BMI is a racist tool to be used to pigeonhole people into a classification that is unworthy of its status in the medical community.

“There is growing criticism for the use of BMI. For example, it does not take body composition (fat versus muscle) into account, and a person’s weight does not correlate directly with their health. However, there’s not much mainstream discussion about its racist roots or the way it furthers the oppression of and discrimination against certain groups.” — Christine Byrne, HuffPost.

When I go to the doctor, the first thing they see is that I am supposedly overweight. They then make assumptions about me and begin to utilize these metrics of the BMI to determine if I am unhealthy.

I recently went to a new chiropractor for treatment. We had worked together about eight times, but I was not getting better. So, I hesitantly mentioned to him that I was going to go see my primary care doctor about my low back pain and the inflammation I appeared to have.

He became irritated. I knew this would happen; should have been prepared for what came next. Remember — I had only known this man for three weeks. He knew absolutely nothing about me and my history. He started off with, “me and you both have a weight problem. It is what you are eating. Inflammation is caused by eating too much sugar including rice, potatoes and pasta and other starches.” I nodded. I knew all of this. He did not care. He went on to say I am “eating badly and that is what my problem is and you should really look into my weight loss program and that you are having low self-esteem and need encouragement.”

I was taken aback. Who did he think he was? What made him think he could talk to me this way? How did this man who knew nothing about me feel he had the permission to body shame to my face? He did not know me. He did not know that I had recently lost a significant amount of weight. That I was eating healthier than I ever had and that I had good self-esteem. I did not ask him for advice. I tried to stick up for myself, but I was so angry I could barely breathe. I told him I was on good health monitoring plan and that was all I could get out. He went on to say, “if you lost that much weight you must have been really big.” Needless to say, I have not been back.

I have had doctors insist on me having gastric bypass surgery from the moment they walk in the room without any consideration for my circumstances. The medical profession has failed me.

“The racist roots of the BMI go back a long way. Created by Belgian mathematician Adolphe Quetelet in 1832 as the ‘Quetelet Index,’ the scale was created using data from predominantly European men to measure weight in different populations. Although Quetelet noted that it was a population-level tool and not meant to be used on individuals, physiologist Ancel Keys reintroduced the calculation in 1972 as the Body Mass Index, and it has since been adopted by the medical community as a way to measure individual health. A BMI outside the “normal” range … is considered less healthy, and an indicator of greater health risks.”  — Christine Byrne, HuffPost.

“It is racist, and also sexist, to use mostly white men within your study population and then try to extrapolate that and create norms and expectations for women and people of color.” — Sabrina Strings, an assistant professor at the University of California, Irvine, speaking with HuffPost.

I signed up for a boot camp several years ago and they offered an accurate way to determine my healthy weight:

“Hydrostatic weighing, also referred to as ‘underwater weighing,’ it is a technique for measuring the density of a living person’s body. It is a direct application of Archimedes’ principle, that an object displaces its own volume of water. The procedure is based on Archimedes’ principle, which states that: The buoyant force which water exerts on an immersed object is equal to the weight of water that the object displaces” — Wikipedia

When they measured my lean body mass, they determined that I had a high level of lean body mass and that a healthy weight for me would be much higher than the high end of my BMI weight. That is a significant difference. That declaration of my healthy weight being based off facts about me made me more confident that it was accurate and that I could healthily maintain that weight.

These policies of using the BMI to determine health cause BMI to be used to say I have a preexisting condition. I was turned down for health insurance before the Affordable Care Act (ACA). Life insurance companies are charging me more for life insurance because I was considered unhealthy. Once again, this is an example of the “Black Tax.” It costs more, in many ways, to be Black.

Doctors and insurance companies need to seriously look at the measures they are using to assess what is healthy. They are using the lazy way out with this simplistic, racist and sexist model. I have felt bad about my weight my entire life, thinking I was always unhealthy and fat. That is not actually true. So, while I was striving for the perfect BMI, I was destroying my body and my self-image. Now I know my healthy and maintainable weight based on my body make up, and I can strive for that.

More: The BMI Is Racist And Useless. Here’s How To Measure Health Instead.

For more on how health care racism is harming Black people, check out this article from The Mighty’s Renee Fabian.