Eradicate BMI and the prescription of weight loss from our healthcare system

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The American healthcare system's reliance on the Body Mass Index (BMI) and the prescription of intentional weight loss perpetuates deadly fatphobia, harming thin and fat patients alike. The BMI, originally known as the Quetelet Index, remains largely unchanged since its creation in the 1800s by a sociologist--not a medical doctor. It was intended to be used as a statistical tool to measure populations, not to diagnose health in individuals. Its creator, a Belgian named Adolphe Quetelet, sought to quantify "the average man" and enlisted only white, European men when developing his Index. 

The resultant prescription of weight loss based on an individual's BMI is consistently met by severe resistance from the body which then launches a complex, multi-system effort to restore the lost weight over time. Ninety-eight percent of dieters will gain back all the weight they lost, and up to two-thirds of individuals will gain more weight over a period of three to five years. The evidence for this is as strong as the evidence that smoking causes cancer (level A). Additionally, there is evidence that an "obesity paradox" exists in which patients living with a growing list of chronic diseases who have higher percentages of body fat live longer than their thinner counterparts. 

Due to the BMI's racist and patriarchal roots, Black and brown women are most disproportionately affected.  This contributes to systemic weight-based discrimination and increases morbidity and mortality rates among people of color. The BMI and prescription of intentional weight loss can NOT be considered evidence-based and their continued use is akin to medical racism.

Credit to Dr. Sabrina Strings whose book "Fearing the Black Body: The Racial Roots of Fatphobia" informed the history of the BMI, You can buy her book here: