I Am “Morbidly Obese” and Other Reasons Why BMI is BS

I had a physical with my doctor yesterday and he told me something that doctors have been telling me since I have exited the womb (literally — I’ve read doctors reports saying this very same thing when I was only a few months old):

“You need to lose weight.”

Okay.  What else is new?  If I had a dollar for the number of times people (doctors but also relatives who don’t know me, don’t have an MD but who mistakenly think that they are experts in my health) told me this, I could afford a suite in the Trump Tower right beside Melania.  Save me a seat.

“Have you heard of BMI?” (BMI stands for “Body Mass Index.”)

“Yes…  I know — according to the BMI, I am obese.”  Wii Fit made sure to let me know each and every time I stepped on that blasted Wii board.  I’ve heard it all before.  And I disagree with it.

“…Yeah…morbidly obese…”

Excuse me?  Morbidly obese?

Over the course of my life, doctors have often told me to lose weight, but I am unconvinced that it has always been for “health reasons.”  Fat phobia and bias are rampant in the medical profession.  They look at the BMI chart and then they see that I am off the charts and then they conclude that I must do something about it.  Some have even flippantly told me, “Stop eating.”

I’m not skinny, but then again, I was never meant to be skinny.  I have stayed in or around the same weight since grade 8.  I never wanted to be skinny.  I LURV being curvy.  I really do. ❤ I also love being active.

Most notably though, my bloodwork is excellent.  My blood sugar has been tested multiple times over the past few years, and all of it — random glucose, fasting glucose, Hemoglobin A1c (which is the best indicator of diabetes) — all of it falls within healthy ranges.  My cholesterol is good.  My blood pressure is excellent.

I walk to work.  I walk home from work.  I walk everywhere because I don’t have a car, and I avoid taking the bus when I can because I’m stingy.  I clock in 10 000 to 20 000 steps a day.  I teach Zumba six times a week, and then go to the weight room after class to strength train.  I try to drink lots of water.  While I admit that my diet can use a little less sugar and a lot more veggies, I eat pretty well — nutritionally dense, whole food (nothing processed), most of which is prepared by yours truly from scratch (shameless plug for my food blog).

Technically, I’m one of those people who are “fat and fit.”

I asked him about this.  He replied, “Yes.  But weight loss is still good.”

I walked away from his office deep in thought.  I like my doctor.  He’s a very nice guy.  He wasn’t rude.  And I agree with him — to an extent.  I mean he is my doctor and I value his professional opinion.  If I knew all of the answers I would not have gone to see him in the first place.  So I won’t act like I know more than he does.  And yes, I will readily admit that I can stand to lose a few pounds.  Weightloss wouldn’t be a bad idea.  After all, diabetes doesn’t just run in my family — it courses through our veins.  I also respect that he has a professional duty to tell his patients to lose weight if that is what the data shows him.  So yes, I will take his opinion under advisement.

But let’s get this one thing straight — I am not morbidly obese.

This is why using BMI as an indicator of health bothers me. BMI is problematic.  It is simply a ratio that measures my weight against my height.  It doesn’t measure my waist circumference or body fat distribution (i.e. weight around the waist is a better indication of a metabolic syndrome or insulin resistance).  It doesn’t measure the amount of muscle I have — and I have a lot.  I remember doing a body composition analysis on a cruise once, and it was the first time I learned that I wasn’t just “fat” — I was built.  If I remember correctly, I was told that I can burn 2000 kcal just resting — without any additional exercise.

According to BMI, I should be 150lbs.  I can assure you, however, that if I, Simone Samuels, was ever 150lbs, I would be dead or close to it.

My body just isn’t made that way.  Neither are the bodies of many world championship, Olympic athletes (i.e. the fittest people on earth), which leads me to believe that BMI is BS, and I am at a loss as to why doctors still use it as an indicator of health.

Here’s one reason: They use it because it’s easy.

Here’s a bit more info for you:

From the CDC:

“The clinical limitations of BMI should be considered. BMI is a surrogate measure of body fatness because it is a measure of excess weight rather than excess body fat. Factors such as age, sex, ethnicity, and muscle mass can influence the relationship between BMI and body fat. Also, BMI does not distinguish between excess fat, muscle, or bone mass, nor does it provide any indication of the distribution of fat among individuals.

The following are some examples of how certain variables can influence the interpretation of BMI:

• On average, older adults tend to have more body fat than younger adults for an equivalent BMI.

• On average, women have greater amounts of total body fat than men with an equivalent BMI.

• Muscular individuals, or highly-trained athletes, may have a high BMI because of increased muscle mass.”

From the International Journal of Obesity:

“Body mass index (BMI) has various deficiencies as a measure of obesity, especially when the BMI measure is based on self-reported height and weight. BMI is an indirect measure of body fat compared with more direct approaches such as bioelectrical impedance.”

NPR lists the top ten reasons why BMI is bogus.  This HuffPost article explains why BMI is wrong for most people.  Based on the BMI’s logic, Olympic shot putters, all NFL players, and even my beloved Dwayne Johnson would all be considered obese.

I love this post from Morit Summers because I can relate:

View this post on Instagram

Yesterday I walked into the Doctors office with nothing on my mind other than, I hope I do not have to wait to long. Very quickly, the conversation turned to my weight. I feel truly confident and healthy these days, so even though doctors always bring up my weight, this time it really shook me. I weigh about 228 right now, and while the number on the scale is high, my blood pressure, my cholesterol, and my resting heart rate are all great! I also have a fair amount of muscle mass. I eat well (for the most part) and as you all know I work out a lot! Now what I'm not sure you all know is that I have PCOS and Lupus, 2 things that make my life just a little bit different than the next person. Not harder, just different. I do everything I can to keep myself as heathy as possible, and yet somehow every time I go to the doctors my weight becomes the focus. My doctor today was super nice and did not mean any harm by bringing this up, but she asked if I wanted to go on drugs for weight loss. My obgyn has asked me multiple times to think about gastric bypass. Even the most confident person would not have felt good after this. Why should I have to feel terrible about myself every time I leave the Doctors office? I feel that it is important to share this because I'm sure I'm not the only one who this happens to. I also know that I am heathy and very capable and I will get over what yesterday's appointment made me feel like. Instead I will use it as motivation and to keep doing my thing!

A post shared by Morit Summers (@moritsummers) on Apr 25, 2017 at 2:14pm PDT

Anowa Adjah is over 200 lbs.  Don’t tell me she’s obese:

https://www.instagram.com/p/BUmflW-A30C/

I am not morbidly obese.

I am not morbidly obese you hear me?

Let me say that again — nice and loud and clear:

I

AM

NOT

MORBIDLY

OBESE

I am fit.  I am strong.  I am muscular.  Hell, I’m even heavy.  But morbidly obese — I am not.

Sure — this hourglass has a few extra minutes.  In fact, this hour has more than twenty-two minutes. (Get it?  “This Hour Has 22 Mins” is a show, but since I’m a little rounder I have more than 22 minutes? Ha ha. No? Okay.  Anyways, I lie — I don’t even have an hourglass figure).  Sure — I can stand to lose a few pounds (and I might add, I probably should and will).  Do I have cellulite?  Yes.  Have I gained weight or has my weight fluctuated over the past few years? Yes.  Do I have stretch marks?  Plenty. Do I have big boobs? Damn straight.  Does my butt jiggle when I walk? A little bit.  Do I have back rolls?  Yup.  Do I have love handles?  Yizzurp.  Do I have a tummy?  Certainly.  Do my thighs rub when I walk? Darn skippy they do.  Thick thighs save lives.  Morbidly obese though?  Like, so fat that it might kill me?  My phatness kills the haters but my fatness doesn’t look like it’ll kill me anytime soon.  You can’t tell someone’s health by looking at them, but my point is, if only by looking at me, I think it is quite obvious that of all of the things that I am, I am not morbidly obese.  Thank you very much.