Created by Adolphe Quetelet, who studied astronomy, mathematics, statistics and sociology, BMI was based in sociological thought rather than medicinal. He NEVER traditionally or officially studied medicine. His work was instead based in sociology, and was rooted in finding the social ideal, the l’homme moyen (the average man). When Quetelet was publishing works in the early 19th century in Western Europe, there was a remarkable rise in racist science being published. For example, this was the era that criminologists like Cesare Lombroso began establishing theories that people of color were actually a separate species, and their physical characteristics were linked to primates. Because of this, Lombroso made the long-lasting thesis that people of color are inherently criminal.

Quetelet believed that the mathematical mean of the population indicated its ideal. BMI was created to directly prove this thesis. His formula was used based only on the size and measurements of French and Scottish participants. Quetelet developed BMI to measure populations, not individuals, for statistical purposes rather than health purposes. Additionally, the populations which it can be applied to are ONLY western European men. So, why is it used today by physicians for their patients of all races and genders?

BMI wasn’t considered as a primary resource for health until the beginning of the 20th century, and is directly tied to the US. When American life insurance companies wanted to determine how to charge their prospective policy holders, they needed an easy formula to apply to a large population. BMI was exactly that for these businessmen, as it was a simple table of height and weight--two things which every human has. By the 1950s and 1960s, physicians began evaluating their patients with their insurer’s rating tables.

So, not only was BMI created by a social scientist to prove some kind of white supremacist ‘ideal man’ image, it was also encouraged through capitalism as a means to make easier money. And despite both of these core purposes in BMI, the scale has only become more prevalent in medical diagnoses and widespread social recognition of health.

In the 1970s, Ancel Keys, an American physiologist, and a group of researchers conducted a study to find a more effective measure than the original BMI. The study included 7,500 men (ZERO women) from five different countries, and was aimed to find the most effective of medicines’ existing measures of body fat. They wanted to find a system that would still be easy and cost-effective enough for regular office visits. The five countries from which the men were selected were the US, Finland, Italy, Japan and South Africa. However, their findings apply to “all but the Bantu men” from South Africa, again emphasizing a lack of interest in understanding people of color. With the exception of the Japanese men, the overwhelming majority of the findings were based on white male health.

Nonetheless, Keys and his researchers determined BMI to be the most effective of existing measures, based on the fact that it accurately detected ‘obesity’ about 50% of the time. And these findings stuck. Based on this, why should we be surprised that women and people of color are disproportionately diagnosed for conditions across the board?

The National Institutes of Health revised their definition of obesity to be based on individual patient’s BMIs by 1985. However, they again changed their definitions of ‘overweight’ and ‘obese’ in 1998, so that it became signficantly easier for someone to be diagnosed as overweight or obese. A CNN article wrote, “Millions of Americans became ‘fat’ Wednesday--even if they didn’t gain a pound.”

The Endocrine Society published studies that show that BMI overestimates fatness and health risks for Black people. Also, the World Health Organization found that the BMI underestimates health risks for Asian communities as well. The BMI also fails to acknowledge any sex-based differences in body fat ratios and BMI. How effective can BMI really be then?

In a 2014 published in the US National Library of Medicine reported a clear negative association between patient-physician communication and patient’s obesity status, meaning that obese patients were treated differently by their physicians in terms of respect, time given, attention given, and patient involvement in treatment decisions.

Dr. Scott Kahan, director of the National Center for Weight and Wellness in Washington, D.C., told TODAY in an interview,“Doctors get almost no training in obesity or nutrition in medical school or residency. They don’t have the skill set to counsel patients and they don’t have the context for understanding obesity.”

The issue of BMI is complex, and one that requires much deeper understanding and awareness both in the general public and in the medical sphere. As long as we rely on BMI as a measurement of health, we will continue to perpetuate the white supremacist, patriarchal notions of ableism, sexism and racism.

As always, the staff at the LWGRC are available for any guidance or support and can be reached at lasallianwomenandgender@gmail.com, via instagram or twitter at @mc_lwgrc, or in our office in room 3C in the Student Commons.

CAMPUS RESOURCES:

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