Shane Collins

Mrs. Lohmeyer

English 101

8 December 2017

Is the Body Mass Index, a Valid Measure of Health?

First of all, what is BMI and what is it for? The Body Mass Index is a screening tool

measuring the correlation between your height and weight, and the percentage of your body that

is fat. The BMI was created in the 1830s by a Belgian astrologist and mathematician by the name

of Lambert Adolphe Jacques Quetelet (The Origin..). It has been used over the years to classify

people of society into one of four groups: underweight, normal weight, overweight and obese.

Where a person falls on the Body Mass Index is calculated by taking a persons weight in

kilograms and dividing it by the same persons height in meters squared. The BMI has several

questionable issues, and therefore, may not be a valid measure of how healthy a person will be in

the future.

The relationship between body fat, health, and obesity has been a topic of conversation

for nearly 200 years. In a world that is focused on what is healthy and what is not, the tools used

to classify people in these areas must be accurate. One of the most common and most recognized

tools, the BMI, has created confusion when determining a persons health. A person should not

be considered unhealthy because of one plot on the BMI chart.

Research programs across the United States have been looking closer into the accuracy of

the BMI to predict health and are finding this tool may not be as accurate as originally believed.

Researchers from the Perelman School of Medicine at the University of Pennsylvania point out
that the body mass index (BMI) is not an accurate measure of body fat content and does not

account for critical factors that contribute to health or mortality, such as fat distribution,

proportion of muscle to fat, and the sex and racial differences in body composition (Ahima and

Lazar). A person can be of healthy height and weight on the BMI chart and still have worse

health problems than an overweight individual. The National Heart, Lung and Blood Institute

found results that were comparative. Our results are consistent with those of a number of other

studies that have failed to show an elevated mortality risk for persons with BMIs of 25.0 through

29.9 but our results do indicate a sharply higher mortality risk for those with low and very high

BMIs (Strawbridge, William). Research is showing that we are unable to use the BMI to

generalize the future health of everyone.

Until now I had always thought that most people believed the BMI was not an accurate

measure of body fat or health. I have found that what average people believe is not true

compared to much of what the research is showing. Also with this new information, I realize it is

not that the BMI as a tool is wrong it is that we are using it to determine future health outcomes

it cannot accurately predict. An article published by the Centers for Disease Control and

Prevention states A high BMI can be an indicator of high body fatness. BMI can be used as a

screening tool but is not diagnostic of the body fatness or health of an individual (CDC).

Individuals need to remember this is a tool for helping to find early signs of risks for health

issues, not for gauging overall general health.

The body mass index is the most common screening tool used by the medical profession,

but it is not accurate when used on all types and ages of people. A persons genotype,

metabolism, energy intake, and level of physical activity (Ross, Nancy) can affect the accuracy

of the BMI. First, the BMI cannot and does not differentiate between muscle tissue and fat tissue.
An athlete can be classified incorrectly because the extra weight carried in muscle mass may

exceed the recommended body weight for their height. Second, it doesnt work for all children as

growth patterns differ among each child. In one year a child could go from being classified as

moderately obese to possibly being in the normal range following a growth spurt. This is a cycle

I can relate to as I bounced back and forth between moderately obese and a normal body weight

for many years. Unfortunately, these inaccuracies cannot help predict the health of a person in

the future, and might in fact cause a cycle of negative health choices.

Society has been using the BMI incorrectly for many years to predict how healthy a

person will be in the future and how long they will live. Generalizing life expectancy based on a

screening tool is misleading. According to William Strawbridge A recent summary of a number

of studies concluded that mortality does not increase sharply until a relatively high BMI (above

30.0) is reached. The BMI itself is not to be used to tell how healthy a person is. Health

professionals need to educate people on what the BMI is supposed to be used for and what it says

about current health. The BMI is not an accurate way to predict the future health of a person.

I did some primary research and traveled to our local clinic to ask a healthcare professional

what their opinion was about BMI. I spoke to Charity Hathaway a RN-BSN at my local clinic.

She had this to say on the topic of the accuracy of BMI for all age groups:

The Body Mass Index is often used as a screening tool to determine if your weight might

be putting you at risk for various health problems. It is not; however, a diagnostic tool.

Health professionals need to do further assessments. In the case of average Americans it

can be an accurate screening tool. For kids there are certain classification systems for

BMI levels. The CDC growth charts and the International Obesity Taskforce (IOTF) cut
 points are the main two. BMI is a tool, and cant be over analyzed as a definitive marker

of needing to lose weight. (Hathaway)

Hathaways opinion supports my other sources in questioning the BMI accuracy in all age

groups. Hathaway explained to me that the BMI had many faults but the biggest was that it cant

differentiate between fat and muscle.

The biggest fault with BMI is that it is unable to differentiate between adipose (fat) tissue

and muscle mass. As a result, some people, such as heavy muscled athletes, may have a

high BMI even though they dont have a high percentage of body fat. In others, such as

elderly people, BMI may appear normal even though the muscle has been lost with aging.

(Hathaway)

In response to my question of whether the Body Mass Index can be used to classify a person

as healthy or unhealthy Hathaway stated:

Body Mass Index, which is based on height and weight of a person, is an inaccurate

measure of body fat content and does not take into account muscle mass, bone density,

overall body composition, racial and gender differences. Used as a noninvasive tool, it

can be helpful in identifying those at risk of developing health problems that can often be

managed or avoided by staying in a healthy BMI range. It is not a classification system in

declaring as healthy or unhealthy, but rather to keep checks and balances of knowing

where an optimal weight should be maintained in regards to an individuals height.

Changing the body composition of the weight can alter the risk factors of developing

illness. Converting fat to muscle will make one healthier, but the number on the scale
 may not change, thus the BMI is the same and proves BMI itself is not used to classify a

person as healthy or unhealthy. (Hathaway)

This personal interview gave me a new perspective on what the health professionals believe.

They dont believe that the BMI is incorrect, they believe that it is being used incorrectly by a

majority of society.

Advocates for the use of the BMI will push for the access to a universal, simple, health

screening tool. Author Jenna Braddock states in her blog for My Fitness Pal, Using BMI works

well for the average person, which is why we see it everywhere from the doctors office to your

mobile-friendly calorie counter (Braddock). I will agree that as a tool this chart may lead

professionals to notice issues in their patients; however, research shows several categories of

individuals who will possibly slip through the cracks or be diagnosed incorrectly. Those

individuals with a high muscular build can be inaccurately classified as unhealthy. If the BMI is

used as a tool it can be helpful, but it should never be used as a diagnosis if health alone.

Studies continue to show that the Body Mass Index is not a one size fits all calculation.

When it comes to a persons health it is very important to have accurate information.

Inconsistent information can lead to poor health decisions for everyone. One of the most

common and most recognized tools, the BMI, has created confusion on determining a persons

health. BMI is purely a screening tool and not to be used to diagnose people as healthy or

unhealthy.
 Works Cited

About Adult BMI. Cdc.gov, CDC, 29 August 2017,

https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html .

Braddock, Jenna. What BMI May (Not) Say About Your Health. MyFitnessPal.com, 2 November 2015
http://blog.myfitnesspal.com/what-bmi-may-not-say-about-your-health/ . 21 November 2017

Hathaway, Charity. Personal Interview. 21 November 2017.

Perelman School of Medicine at the University of Pennsylvania. "BMI not accurate enough:
Obesity/mortality paradox demonstrates urgent need for more refined metabolic measures."
ScienceDaily. ScienceDaily, 22 August 2013.
<www.sciencedaily.com/releases/2013/08/130822141948.htm>. 21 November 2017

Ross, Nancy A., etal. Body Mass Index in Urban Canada: Neighborhood and Metropolitan Area Effects.
American Journal of Public Health, vol. 97, no. 3, Mar. 2007,
EBSCOhost,doi:10.2105/AJPH.2004.060954. 21 November 2017

Strawbridge, William J., etal. New NHBLI Clinical Guidelines for Obesity and Overweight: Will They
Promote Health?. American Journal of Publication Health, vol. 90, no. 3, Mar. 2000, EBSCOhost.
www3.nothern.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=hc
h&AN=2856524&site=ehost-live. 21 November 2017

The origins and limitations of the BMI. Cut the waist.com, Cut the Waist, 2011,
http://www.cutthewaist.com/bmi.html . 8 December 2017