Biostatisticians Manufacturing Insecurity

obama not trueThere’s been a small flurry of press around one of the latest entries to my ever-expanding reading list, Dr. Carl Lavie’s The Obesity Paradox: When Thinner is Sicker and Heavier Means Healthier.

This story over at Good Morning America is pretty typical of what you might expect from such coverage:

  1. gasps of surprise at the notion that fatness and fitness could coexist in human form
  2. the usual journalist concern-trolling comment about “won’t this just let overweight people feel okay about themselves?” — because it would, of course, be awful if any fat person actually had self-love or self-acceptance*
  3. a concluding tag from the network medical editor desperately trying to reaffirm the badness of fatties and the continued relevance of using the BMI (“body mass index”) as a measure of your general health and fitness.

It’s almost enough to make me giving up watching my usual morning news show, because here’s the thing: BMI is not in the slightest bit a relevant or useful measure for someone’s health or fitness.

The person who dreamed up the BMI said explicitly that it could not and should not be used to indicate the level of fatness in an individual.

The BMI was introduced in the early 19th century by a Belgian named Lambert Adolphe Jacques Quetelet. He was a mathematician, not a physician. He produced the formula to give a quick and easy way to measure the degree of obesity of the general population to assist the government in allocating resources. In other words, it is a 200-year-old hack.

At least The New York Times is taking a more reasonable approach in its response to Lavie’s book. (Of course, the Times employs Gina Kolata, so I’ve come to learn I can expect a little bit better of them than from the usual muck-raking hacks.)

It’s a little frustrating to have all of this trumpeted as if Lavie’s saying something that’s never been said before, when this is ground that’s been well-trod by Linda Bacon, Paul Campos, Eric Oliver, and yes, Gina Kolata. But I guess I’d rather have more and more sources revealing these inconvenient truths, in hopes that we’ll hit a point of critical mass and the cultural discourse will turn.


Prompted by all this recent conversation about the BMI, I was inspired to do two things.

First, I took a trip down memory lane and over to Shapely Prose’s BMI Project: a set of pictures that shows the wide variety of beautiful, healthy woman and men who would be stigmatized as over or underweight all because of this fucked up wacky BMI obsession.

Second, I did some math to figure out where I currently fall on this dreaded rubric and what the delta is between my current shape and the holy grail of a BMI equalling 24.9 or below. Current BMI: 35.2, which matches me exactly to one of the BMI project folks on the top row of the flickr page. Pounds I would need to drop in order to reach 24.9: 64.

Which is totally fucked up bananas. It is even more clearly bananas when I look at my “BMI twin” on the Flickr set and try to imagine it.

(It’s that old trick of being able to see more beauty in and feel more compassion for others than for the self. Heck, I’ll use whatever’s in my arsenal to keep growing my level of self-love and body acceptance.)

* Here’s when I started screaming at the TV. I think I scared Mr. Mezzo.


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5 thoughts on “Biostatisticians Manufacturing Insecurity

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