Women and Weight: 4 Ways to Think Beyond BMI

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If you’ve been to the doctor recently, you’ve likely received one of those lengthy printouts summarizing your visit, including providing detailed information on your weight and the corresponding body mass index (BMI) percentage, a number that physicians use to assess individual nutritional and health status¹. While it continues to be a part of the accepted medical canon, the utility of using BMI as a measure of health has been questioned in recent years due to variations in individual body frame, height, and muscle mass². To help you prepare for your next visit, here are a few other ways to think about the connection between weight and health that go beyond BMI.

1. Adopt a "health at any size" perspective

Health at any size is a perspective that supports enhancing the health of all people, regardless of body size or weight³. It is an inclusive approach to understanding health that values the person in their social, psychological, and environmental context. Most importantly, it does not support assumptions about a person’s size or BMI as an absolute measure of overall health. How do we talk about this perspective with our doctors, who likely have not been exposed to this idea within the medical model? One way to do this is to talk with your doctor about what health at any size means and how you are applying it to your life. Then, invite them to support you in examining other areas of whole-person health they consider important outside of just BMI.

2. Learn about the connection between metabolic health and weight

Another way to think outside the BMI framework is to understand the relationship between metabolic health and weight. Measures of your metabolic health include things like your blood pressure, cholesterol (HDL and LDL), triglycerides, and blood sugar levels. Studies have shown that up to 40% of individuals who meet the current criteria for obesity are metabolically healthy, that is, have levels of these metabolic health factors that are within the normal range⁴. Encourage your doctor or other healthcare staff to review your labs and discuss them with you in order to understand how your metabolic health is connected to your weight.

3. Keep in mind the weight-related changes that come with age

With age comes wisdom and sometimes more weight. Due to a decline in physical activity as we age, the loss of muscle mass, and things like childbirth and menopause, weight gain can increase as women age. In fact, even within significantly active populations, weight gain has been found to increase through middle age, more so in women than in men⁵. This isn’t to say that we should give up on exercise or living a healthy lifestyle, but it does help to maintain an awareness of what’s within our control. Don’t be so hard on your aging body.

4. Tune in to your relationship with food

Lastly, and perhaps most importantly, understanding our relationship with food can give us a key understanding of how we view ourselves in terms of our weight and the body image messaging we have received over the course of our lives. Rather than measuring our worth based upon a number, whether it is BMI or the number on the scale, we would do so by being kinder to ourselves. This means recognizing when we have placed unnecessary moral judgments on foods (‘good and bad’ foods) as well as when we have fallen into marketing schemes that tell us certain foods are ‘clean,’ implying that what we’re eating is ‘dirty’—not a good feeling⁶. Having a healthier relationship with food is a key element in achieving overall health, one that we can all strive for regardless of BMI.