The BMI is Outdated and Harmful to Health
BMI (Body Mass Index) was never meant to be used as a tool for individual health assessments. It was created in the 1800s by mathematician and astronomer Adolphe Quetelet, whose original goal was to study population trends—not to assess someone’s personal health. Quetelet himself was clear that BMI should not be used as a measure of health. On top of that, his data only included European white men, so it wasn’t even a diverse sample!
When we use BMI to measure health, we reinforce harmful stereotypes, stigmatize people with larger bodies, and create a vicious cycle that worsens both healthcare quality and patient outcomes.
The Stress of Being Weighed at the Doctor’s Office
For many people, stepping on the scale at the doctor’s office is a source of anxiety—so much so that some may even avoid healthcare altogether. The use of BMI as a “health indicator” has led to a lot of confusion about what actually defines health. The problem becomes clear when we see healthcare providers applying populational trends from studies to individual patients without considering key lifestyle factors like physical activity, nutrition, or weight cycling (the yo-yo pattern of losing and gaining weight, often due to dieting).
When studies control for lifestyle factors, there is no longer a significant difference in mortality across the different BMI categories. In fact, there's little to no difference in mortality rates between people in different BMI categories when we look at things like produce consumption, exercise, smoking, and alcohol consumption. Simply put, BMI doesn’t predict our risk of death when we apply solid science.
Even If BMI Did Predict Health, It Still Causes Harm
Let’s say, for a moment, that BMI did accurately reflect health and mortality risks. It still wouldn’t justify using it as a tool for judgment. Labeling someone’s body as “wrong” or “unhealthy” based on their size does real psychological and physical harm. There is no “wrong” way to have a body, and everyone deserves to feel accepted and respected—regardless of their size. Aubrey Gordon has written an excellent article on the history of the BMI and its harmful implications.
The negative effects of weight bias are well-documented. Experiencing discrimination because of body size—independent of BMI—can lead to higher blood pressure, increased cortisol levels, a greater risk of diabetes, and worse heart health. Ironically, by focusing on weight, the healthcare system often worsens the very health outcomes it’s trying to prevent.
The Harmful Impact of Weight Bias in Healthcare
Unfortunately, BMI and weight stigma have become so ingrained that they’re often used as a way to judge people’s lifestyle choices. This leads to poorer care for those in larger bodies. Studies show that physicians tend to spend less time with patients who have higher BMIs, often due to internalized biases. Patients notice this, which can lead to worse healthcare experiences, misdiagnoses, and a lack of appropriate treatment.
In reality, a person’s weight doesn’t tell us much about their behaviors or health habits, but healthcare providers still use it to make assumptions. This perpetuates a cycle of misunderstanding and harm.
Moving Away From BMI: A Healthier, More Respectful Approach
Given the social climate and the moral baggage that comes with BMI, it’s clear that it cannot be ethically used as an individual marker for health. Judging a person according to their size doesn’t improve health—it only perpetuates stigma.
A weight-inclusive approach to care focuses on the unique identities and experiences of each person, without the harmful influence of diet culture. This is a much healthier, more respectful way to approach well-being for everyone.
