The Bizarre and Racist History of the BMI

Body Mass Index has been used in recent decades as a referendum on individual health. But it was never meant to be.

Your Fat Friend
Elemental

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A woman checking her weight on a scale.
Photo: Zave Smith/Getty Images

II walk out of the doctor’s office, swiftly folding my after-visit summary packet and tucking it under my arm. If I don’t, the strangers in the waiting room will see its bold lettering in an oversized pull-out box on the first page. BMI: 47. Super morbidly obese.

My Body Mass Index (BMI) has come to feel like a scarlet letter. It has become not only a referendum on my size, but also on my health and subsequently my character. The logic is ruthlessly consistent: anyone my size must have committed a series of unforgivable acts. I must have let myself go. I must be pathological in my need to eat, my greedy desire to stay still. This is a pathology deserving only of disdain, never empathy. Clearly, I have been derelict in my duty to keep myself thin.

Like most of us, I’ve come to accept the BMI as a simple truth. It is, I have been taught, a direct measure of my size and health. But for something as universally relied upon as the BMI, its history is much less solid — and scientific — than you might think. For many of us, especially people of color, medicine’s over-reliance on the BMI may be actively harming our health.

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Your Fat Friend
Elemental

Your Fat Friend writes about the social realities of living as a very fat person. www.yourfatfriend.com