Today’s Read: For the Physicians

medication pills isolated on yellow background

TW: Fatphobia

I’m considering carrying copies of this article to every medical appointment I have. I never want to hear about BMI again. If you’re in the medical field, tell your coworkers about this, please. It’s not a secret. It’s not new information. I’ve read about this repeatedly.

BMI is bullshit. Weight is one’s relationship with gravity. BMI is length plus width. They’re literally just numbers. They don’t tell anyone anything about health.

To be clear, I’m not saying one’s body size has zero impact on health. On the contrary, I know how my body size impacts my health. I’m saying we cannot limit our understanding of health to BMI, weight, height, or any combination of those numbers.

For instance, my doctor’s main nurse called me to tell me I’m pre-diabetic. (My chiropractor later said, “Technically, we’re all pre-diabetic.”) Instead of asking me about my diet, she said, “Stop drinking sugary drinks entirely.” She did not ask me how many sugary drinks I have in a day, how many ounces, how often, etc. I could tell the assumption was that I drink soda often. I typically don’t. I drink yogurt, chai, sparkling water, and filtered water. That’s usually it. I might have a week where I drink a soda once a day, and then I’ll go months without drinking soda at all. I rarely exceed one chai in a day. I simply don’t drink a lot of sugar, but that was the recommended medical advice.

The relationship here is this: Obese + pre-diabetic = bad eating habits.

But consider this as well: I learned recently I have severe sleep apnea. Maybe I consume carbs a lot because my body is in need of quick energy because I sleep like shit. So, why wasn’t my medical care team asking me about my holistic health instead of giving me impersonal directives? Why weren’t the questions: What’s your sleep like? How much energy do you feel like you have in a day? Are you often tired?

The relationship is actually this: Sleep apnea –> Poor sleep –> Low energy –> heavy carb consumption –> Higher than average blood sugar

Now, I’m willing to acknowledge my body size might contribute to sleep apnea. But we don’t know. Thin people also have sleep apnea, so weight is not an obvious, universal factor. What might the underlying concerns be, and why aren’t my doctors asking those questions?

We pay far too much money in office visits, health insurance, and pharmaceuticals to be given one-dimensional answers based on two-dimensional measures for three-dimensional bodies. We cannot all agree that bodies are different, then use the same measuring stick for everyone. The medical industry makes too much bank to sit on old, flawed, useless knowledge. It’s time for them to change. Ban the BMI.

Talk to me!