BMI Is BS, So How Do You Really Know If You're Healthy? Experts Weigh In
In case you haven't already gotten the memo, BMI, a measurement commonly used to determine whether someone is overweight or obese, is BS. Confirming doubts many experts have already cast, a new study in the International Journal of Obesity shows why BMI is the wrong way to measure health: Nearly half of "overweight" people are healthy by other measures, including glucose, cholesterol, triglyceride levels, and blood pressure — the very indicators BMI is supposed to predict. Not to mention, nearly a third of people with "healthy" BMIs are actually not healthy by these metrics.
Hopefully, this study will be the final nail in the coffin of a system medical professionals have long considered irredeemably flawed. After all, this is the calculation that considers Tom Cruise, Mel Gibson, and Sylvester Stallone obese and classifies Tyra Banks and Johnny Depp as overweight.
According to nutrition therapist Theresa Kinsella, both BMI and weight are poor indicators of health and body composition. Waist size is a better measure of how much fat is in your body, but Kinsella urges forgetting about measurements and focusing on behaviors.
Erica Leon, a dietician specializing in eating disorders, said she has seen many disorders triggered by doctors who told kids their BMIs were accelerating, when, in reality, they were just undergoing growth spurts. "A larger body can in fact have excellent laboratory parameters of health — normal cholesterol, blood sugar, and blood pressure," she said. "'Health at every size' is a better philosophy, since your behaviors favor health, NOT your weight or size." Kinsella agreed:
BMI was originally created to be used for studies that look at populations, not individuals. It doesn't take into consideration body composition or health behaviors. Many people would be better off focusing on self-care behaviors such as adequate and quality sleep, regular exercise, a regular eating schedule, eating in attunement with the body's hunger and fullness cues, and choosing foods that provide energy and feel good physically.
So, here are some ways to discover whether you're eating right, exercising right, and at the right weight for you that have nothing to do with your BMI.
1. Can You Maintain Your Weight Without Torturing Yourself?
If you're constantly hungry, exhausted from exercise, or eating to the point of discomfort in order to maintain your weight, you're probably not at a healthy weight for you, no matter what your BMI charts say. Weight, Leon pointed out, varies just like height, so a weight that's healthy for one person may not be for another. "If someone is practicing self-care behaviors around sleep and exercise and eating intuitively and regularly, they will be likely to fall into their genetically predetermined weight over time," Kinsella said. Nutrition and intuitive eating counselor Jamie Lee echoed this opinion: "A biologically appropriate weight is reached when a person is able to easily maintain their weight without engaging in disordered behavior, while taking care of one's physical and mental health."
2. Do You Eat A Wide Variety Of Foods?
Different foods have different nutrients, so if you're on a restrictive diet, you're likely missing out on a lot of nutrients that could be helpful to you. Nothing is bad in moderation, even dessert. So, if you get nutritional advice that tells you to cut any food group out of your diet, run in the opposite direction. "All foods can be part of healthy eating, so work on having lots of different foods, including fruits and vegetables, as well as fun foods like sweets," said Leon. Kinsella said the Mediterranean Diet has been shown to provide the most health benefits, but personal preferences are also important to consider when choosing your diet.
3. Is Food On Your Mind All The Time?
It's normal to love certain foods, but being obsessed with eating or weight loss can interfere with other aspects of your life. Not to mention, thinking about food all the time can be a sign that you're malnourished. "Dieting and/or ignoring hunger causes food preoccupation, which in turn can lead to binging and restricting — as well as poor self-esteem," said Leon.
4. Do You Eat For Reasons Other Than Hunger?
Sometimes, it's OK to eat a cookie when you're not that hungry because it will taste better fresh out of the oven or to partake in birthday cake when you don't necessarily feel your body needs it. But for the most part, you shouldn't be eating or depriving yourself of food for emotional reasons. Food should be a way of sustaining you, not of comforting you or proving how "good" you are. Leon instead advocates intuitive eating, or "leaning to eat according to hunger and fullness cues, as well as satisfaction."
5. Do You Associate Food Or Size With Morality?
Even if you don't think of food or weight as a moral issue, you may very well have picked up some associations between eating and morality through the dieting culture we live in. For example, have you ever felt disciplined for ordering the salad instead of the burger? Have you ever assumed someone led a less active lifestyle because of their size? Having a healthy relationship with food means stripping it of all these associations and eating purely based on what your body needs.
6. Do You Feel Good When You Exercise?
Does exercise make you feel upbeat, strong, and healthy? Or does it make you feel drained, bored, or resentful? If you don't like going to the gym, that's OK! There are plenty of ways to exercise, so find one that you enjoy rather than suffering through it for the sake of fitness. If you exercise in order to attain a particular shape, you may have an unhealthy relationship with it, said Kinsella. "Exercise should be pleasurable and energizing, not depleting." She added that most experts recommend at least 150 minutes per week, but the ideal amount will be different for different people. "Take note of how exercise effects energy levels and mood to determine the right amount for you," she advised.
7. Do You Have Rules Around Food?
If you observe the way young children eat before they have been indoctrinated into dieting culture, they will have whatever they're in the mood for, not what books or magazines have recommended. When we learn to follow rules around food, we grow distant from the natural cues are bodies send us about what is right for us at a given time. Granted, advertising and other people can influence what we eat, but if we tune out all these influences and get in touch with our bodies, we intuitively know what we need.
"While it may be more subjective, developing self-trust, eating confidence, and strength in body and mind are often greater predictors of healthy behaviors, which lead to improved wellness," said Emily Fonnesbeck, a dietician specializing in eating disorders. So, if you want to be healthier, taking attention off your weight may help more than any number of pounds you could lose or gain.