The BMI is EVERYWHERE. But is it scientific or scientif-ish? While many Americans think of the body mass index as an objective measure of health, its history reveals a more complicated story. This week, Mike and Aubrey tackle the first in a two-part series about the BMI and the “Obesity Epidemic.” Along the way they visit 18th century Belgium, learn a gross new acronym and dissect Dracula's facial features.
LINKS!:
- The Bizarre and Racist History of the BMI (Elemental)
- Adolphe Quetelet, Social Physics, and the Average Men of Science, 1796-1874 (University of Pittsburgh Press)
- Mindful of eugenics’ dark history, researchers are reexamining the genetics of social mobility (Quartz)
- Adolphe Quetelet (1796–1874)—the average man and indices of obesity (Nephrology Dialysis Transplantation)
- For Researchers on Obesity: Historical Review of Extra Body Weight Definitions (Obesity)
- Quetelet, Adolphe (Canada’s Eugenics Archives)
- Top 10 Reasons Why The BMI Is Bogus (NPR)
- The False Science Linking Body Shape to Personality (The Atlantic)
- Obesity task force linked to WHO takes “millions” from drug firms (The BMJ)
- Impact of weight bias and stigma on quality of care and outcomes for patients with obesity (Obesity Reviews)
08/03/21 • 68 min
15 Listeners
Maintenance Phase - The Body Mass Index
Transcript Summary
In this episode titled "The Body Mass Index," the hosts delve into the history, limitations, and controversies surrounding the measurement of body mass index (BMI). They discuss how the definitions of overweight and obese were changed in the 1990s, potentially influenced by drug companies seeking to expand their market for weight loss drugs. The hosts highlight the biases and journalistic reporting on the "obesity epidemic," the incomplete nature of BMI data, and its use as a proxy for health risks. They explore the discriminatory aspects of BMI, medical biases against fat individuals, and the difficulties fat people face in obtaining fair healthcare. The hosts also examine the origins of BMI with Adolphe Quetelet and its connection to eugenics. They shed light on how insurance companies and doctors began using BMI, the controversies surrounding Ancel Keys' study on body fat, and the official establishment of BMI categories by the National Institutes of Health and the World Health Organization. The hosts critically analyze the limitations and flaws of using BMI as a measure of health and urge for a more nuanced and unbiased approach to understanding body weight and health.
Transcript
[Maintenance Phase theme]
Aubrey: We're ready. I think you're up on intro, yeah?
Mike: This one might be kind of offensive. [chuckles]
Aubrey: [laughs]
Mike: Sorry, in advance.
Aubrey: [laughs]
Mike: Welcome to Maintenance Phase, the podcast that is just right between 20 and 25, too long to 25 and 30, and morbidly too long from 30 to 35.
A
The Body Mass Index Top Questions Answered
How is BMI used to justify eugenics?
Quetelet's work, developed into the Body Mass Index (BMI), was misused by proponents of eugenics to promote ideas of genetic superiority.
How do insurance companies use BMI?
Insurance companies utilize BMI to charge higher premiums for policyholders, creating weight tables based on their own criteria.
When was the first widely used insurance table introduced?
MetLife introduced the first widely used insurance table in 1942.
What are the limitations of BMI as a measure of obesity?
BMI is flawed and can mislabel individuals as unhealthy based on their weight, leading to misclassification of both fat and thin people.
How did fat people seek better healthcare?
Fat individuals, desperate for decent healthcare, pushed for equal treatment compared to thin patients.
What are the biases fat people face in healthcare?
Fat people encounter weight stigma and bias from friends, family, intimate partners, and healthcare providers, often resulting in delayed or substandard care.
How did Quetelet's work contribute to the concept of Social Physics?
Adolphe Quetelet's work on analyzing datasets about people led to the concept of Social Physics, finding patterns in human behavior based on population-level data.
How did the definitions of overweight change over time?
The definitions of overweight have evolved, with BMI cutoffs changing and the World Health Organization adopting the BMI as a global standard in 1995.
Why did the World Health Organization use BMI for children?
Controversially, the WHO started using BMI for children, despite concerns about measuring weight relative to height for growing bodies.
What are the limitations and biases of the BMI scale?
The BMI scale is based on arbitrary standards, lacks diversity in its application, and may not be suitable for all populations, as it varies among races, ethnicities, and genders.
Should efforts focus on weight or health risks directly?
Efforts should prioritize controlling health risks directly rather than using weight as a proxy indicator, as there are more effective interventions available.
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