“Re-examine all you have been told in school or church or in any book, and dismiss whatever insults your soul; and your very flesh shall be a great poem, and have the richest fluency, not only in words, but in the silent lines of its lips and face and between the lashes of your eyes, and in every motion and joint in your body.” - Walt Whitman, Leaves of Grass In my previous rant, based from history and well-documented research, we determined that Body Mass Index (BMI) is simply an outdated measure of how an individual’s height and weight ratio “norms” within all human beings. Although, I will give props where it is due: the BMI does have a benefit of screening within a large population as Mr. Quetelet had originally intended for this formula and as scientist Ancel Keys reiterated this key aspect in the early 1970’s (Read about HERE). However, referring to my previous argument, solely basing health by BMI measurements will, as Swainson contended “fall short in identifying those at an increased risk of associated conditions, in particular cardio metabolic diseases” [10]. So let’s discuss a few common methods of measuring our weight and body fat.
Alternatives to BMI Let’s discuss a few common methods of measuring our weight and body fat:
According to Leeds Beckett University, “Calculating a person's waist-to-height ratio is the most accurate and efficient way of identifying whether or not they are at risk of obesity in clinical practice, a new study...shows” (2017). However, Leeds Beckett University did also share the limitations to calculating a person’s WHtR “was found to be a very poor predictor of obesity according to both measures”. [8]
I should state that I have a personal bias against this form of measurement; I, personally have not had this done, but I have spoken to a handful of women who have had this procedure done in the gym, all of which were incredibly disappointed in the very shallow results. Let me not get started on how this form of measurement does not differentiate between brown or yellow fat (Waaaay too much to cover there, that’s another rant). I wanted to use a direct quote from a friend I interviewed who would like to be kept anonymous: "To have someone pinch the excess skin folds throughout your body and then to hear your fate 'You are obese'... it was humiliating".
If you’re strongly considering losing weight and absolutely need a method of measuring of body fat, all of these should be considered. It can help! To have empirical and tangible data of your own body. It can motivate! To see that number decrease over time. Trust me, I have been there and relate 100%. But do you know where else I have been? 20 lbs from my goal weight and chillin' at a plateau of 150 lbs. I wanted so desperately to be at least 149, I NEEDED to get out of the 150’s. Or stuck at a BMI of 30 a.k.a OBESE still, my waist circumference remained stagnant, even my BIA results had not changed - and I was left feeling deflated. Stick with me as I’m getting to my point here: Why are we still using these forms of measuring body fat? We utilize these many forms of measurements as determinant of health and weight and all seem to have their flaws. Not flaw(s), FLAW: all do not consider all aspects of a person, their body, their heritage and background. In these forms of measurement's defense, it's an impossible task as one form could not consider ALL aspects. Remember each human is a unique and individual snowflake. We have these measurements in place as a general guideline, as determinants of the general population, but think about it -- does the world use these as a ‘general guideline’? Humans have a silly way of holding onto habits, holding onto an idea, onto people…. Ah, comfort-ability! That’s the right word. We love where we are here, because that is what we know, that’s all we have ever known in our little bubbles, and we’ve made it this far, right? We’re okay., right? Or has the world become comfortable with these guidelines, relying on them as rules of thumb, as 100% accurate, as 100% applicable to all. Has anyone stopped to ask a few things: Why are we putting such heavy emphasis on numbers? Are we putting this focus in the wrong place? And a major question: Is there an ideal body weight? Questions we will delve into in my next post. I end my rant today with a quote from Linda Bacon, the author of Body Respect: “Our culture perpetuates the anti-fat myths that keep people depressed and at war with their own bodies… it also reinforces the message that they - not the size-stigmatizing culture - are the problem."[1]
0 Comments
"If you put a crack in someone's 'normal' way of thinking what comes up in it's place is common sense" - Roger Mills and Jack Pransky, pg 259 Originally written December 15, 2017 I ended my last rant with a promise to delve into Body Mass Index, more popularly known as BMI. There is an extensive bit of research debunking this topic as it does not provide one with a guideline for appropriate cutoff values associated with an "ideal weight" but yet this tool is still heavily utilized within the medical and weight loss industry. If you're unfamiliar with BMI, Body Mass Index is a well known “medical” form of measuring health by dividing individuals into categories: underweight, optimal weight, overweight, obese and now morbidly obese. These are determined by a calculation based off the individual’s height and weight ratio. A quick pause for a story: years and years ago, shortly after my weight loss journey began and found that I was making visible progress, I decided to get a routine check up with my doctor. I think I may have already dropped 10 or so pounds - I was feeling great! I had a kick in my step from knowing that I was lighter, I could feel my high spirits continuously lifted from being healthier, I could not be knocked down. I’m checked in, a nurse takes my vitals, weight, blood pressure, standard questions. He asked about my weight and I beam as I tell him I recently lost 10 pounds and he beams back! He congratulates my efforts, he tells me to keep the progress going and he tells me the doctor will be with me shortly. This is always a small fib, but it’s okay because I am glowing with all this positivity. I’m like a small child, swinging my short legs off the examination table, not a care in the world. In comes my doctor, who solely makes eye contact with my chart, and asks why I came in. After explaining I just came in for a standard check up, the doctor blatantly tells me “Well, you’re morbidly obese.” Still no eye contact, let alone a physical examination. This is of course based off of the famous BMI chart he barely glanced at. He pointed where “my category” was, based off of my height (5’1’’) and what weight I needed to be at (100 lbs). This doctor monotonously explains how being at this ideal and healthy weight will normalize my blood pressure as well as many other health aspects, which is true. But then I meekly interrupt him to ask him what my current blood pressure was again. It has been years, so I don’t remember the exact number but I do know that it has never strayed far from the standard healthy 120/80, even at my heaviest. He searches for my blood pressure on his precious chart and falls silent, stunted by his own overbearing attitude. He awkwardly asks if I required anything else from him and makes his way to his next patient. My once concrete easy-breezy happiness from progression of my well-being, of my whole self, sent me into a whirlwind of anxiety, depression and helplessness. Maybe this doctor was having a bad day, maybe this is just the way he is, no matter. What deflated my happiness was in his ease of putting me into a box that I, previously to this moment, did not relate to. Leading to this moment, I knew I had weight to lose, I knew I wanted to be healthy, but I had no idea I was obese, let alone MORBIDLY OBESE. I considered all of my recent hard work that resulted in me losing weight - what was that for if I am morbidly obese?? But then I thought of all the power pump classes I had recently attended, how visibly strong I have become since the beginning of my journey and something did not seem quite kosher. How can this chart tell the difference between muscle and fat? And does it know that muscle weighs more than fat? Does it know if I am a male or female? Does it know my build - because I may be petite but my Latina butt will never be 100 lbs!! Let's calculate an example, shall we? Our example's name will be Johnson. We do not know the examples gender, build, race/ethnicity, sexuality, or their desires/goals for their body. This person weighs in at 260 lbs - based off of this number alone we can already stereo-typically assess that Johnson is heavy set, even though we are unaware of other factors previously mentioned above. We find out Johnson is 6 feet and 5 inches tall.. whoa now.. we have a hefty person on our hands!! Given these numbers, lets check what category Johnson ranks at. According to the Body Mass Index (image above) he is a whooping 31! Riiiiiiiiight over that obesity line. So our assumption was correct.... Johnson is obese. Tsk, Tsk... someone should inform Dwayne "the Rock" Johnson, our example, of this. (Shout out to Google for providing the intimate details) Posing the real question: How did this index with it's many, many flaws become the most popular form of measuring body fat within so many fields? In the 1830’s, Adolphe Quetelet, a Belgian astronomer and mathematician, invented this calculation due of his keen interest in observing human norms as determined by a bell curve. “His pioneering cross-sectional studies of human growth led him to conclude that other than the spurts of growth after birth and during puberty, ‘the weight increases as the square of the height"[7]. This was then known as the Quetelet Index. Essentially, this theory has more to do with the mathematical laws of probability than body fat, disease or mortality [11]. A thought to consider: what are the chances that Quetelet's sample population included those of diverse races? Hmm.. Come the 1940’s: Metropolitan Life Insurance Company implemented this theory as a measurement to determine how much to charge their customers for insurance, without having scientific evidence showing a correlation in weight and health. Soon after, noticing the ease of having generalized categories for their patients, the Quetelet Index was adopted by doctors, epidemiologists and the U.S. Government as a way to determine health based off of weight due to forceful lobbying of a Metropolitan Life statistician [11] named of Louis Dublin [10]. By the early 1970’s, Ancel Keys, an astute scientist who studied starvation in men and author of The Biology of Human Starvation (1950) continued practicing Quetelet Index, officially coining the term as Body Mass Index (BMI) in his article Indices of relative weight and obesity. However, Keys made a point to emphasize that BMI was only relevant for macro studies (large populations) and “completely inappropriate for use in individual diagnosis” [6]. This fell on deaf ears as physicians had a more convenient, non-invasive form of measuring patients health and nutritional standing that simply could rely on a handy dandy calculator. By 1998, BMI took a turn for the worst when the National Health, Lung, and Blood Institute lowered the BMI numbers for all weight categories, making those who were originally at optimal weight to become now overweight [11]. Not only does this measurement have no history of taking into account such control measures as gender, age, race, and cultural background, but also does not distinguish between the weight orienting from fat tissue versus muscle tissue. Therefore given this information based on historical and empirical data, the Body Mass Index is an inefficient form of determining health as its lacking major components such as diversity as well as the distinguishing factor of its inability to determine weight from muscle mass or actual body fat; society is basing a major form of health measurement and categorization off of false information. We can hypothesize that there is no reason for society to have such terms like ‘overweight’ and ‘obese’ then. Granted, yes, there is a childhood obesity epidemic in modern-day America - according to the Centers for Disease Control and Prevention (CDC) in 2011-2014 “the prevalence of obesity remains at about 17% and affects about 12.7 million children and adolescents”[4]. But these determinants are based off of BMI, a proven false measurement of health! The concern here is the labeling of children into categories based off of a false calculation. Entitling children will undoubtedly have an affect on them, but to be labeled in such a manner at an early onset would have a massive impact on a child as they are now determined to be something that is more often viewed as a negative feature within America’s society - not being thin and we all know that thinness equals beauty, right? (See last post on rants on society’s harsh view on beauty and its impacts on men, women and children) I will end here to give you time to mull this over. Next time…. Let’s talk about the healthy alternatives to measure your health! (Yes, they indeed exist!) If you have questions, comments or concerns, I encourage and welcome you to reach out to me! |