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(Yet) another reason the emphasis on BMI is ridiculous

March 23, 2011

Just a few quick thoughts that occurred to me.

I am worried about the state of my bones, especially when I get older. First I had (iatrogenic) endocrine problems that can cause osteoporosis, and now I’ve got the vitamin D deficiency which can cause all kinds of bone demineralizing fun. I’ve got symptoms of osteomalacia. I’m also 36 now; it’s already harder to get them remineralized.

It occurred to me that the main reason I am not having more problems than I am from this now is my BMI.

ATM, I have basically no body fat and a lot of muscle wasting coming from the deficiency. It looks like I have maybe half the muscle mass I used to, especially on my limbs, which are like weak sticks now. My blood sugar has been so out of whack in a way that doesn’t respond to much that I’m staying ravenous and eating energy-dense stuff pretty much constantly to try not to lose any more weight–at this point, muscle mass–from that. At last check, my BMI was 27 or 28. (I don’t even want to dig out the scale to see what it is now, triggering as that is for me.)

Probably the best GP I’ve ever had, working off the old height and weight charts, was saying “take the large frame numbers, and add another 10-15%”. My bones started out big and dense enough that an orthopedist actually commented on it; that’s why, klutzy as I am, I have never broken a bone other than several small ones in my hands and feet (I just keep getting weird soft tissue damage and separating joints instead). I hope this stays true. With the same bone structure, my mom’s BMI never got below 21 when she was emaciated from cancer and still capable of stepping onto a scale.

Without the infrastructure that gives me the high BMI even when without my usual muscle mass, I’d probably be in one hell of a shape already with the demineralized bones. If I hadn’t started out with a lot of muscle, I probably wouldn’t be able to walk ATM. It makes me extra angry that I have been repeatedly insulted, outright verbally abused, and denied appropriate medical treatment (e.g., hormonal birth control) based on said BMI–which has most likely repeatedly saved my bacon. It makes me angry that the old “exercise and lose weight, you lazy slob–oh, and try to relax!” treatment plan has been the major one offered for the D deficiency/osteomalacia pain over the years. I am still angry about the racist components besides the extra gender-based nastiness, too. It makes me angry in very much the same way that getting praised at the doctor’s office for losing 30 lbs. in two weeks from an acute health problem–with serious dehydration, as you’d expect with that amount of loss–pissed me off.

This emphasis on BMI is not about health at all.

I’m not suggesting that this kind of treatment is appropriate in any case, BTW; people deserve more respect than that, and the way BMI is used in general is ludicrous and damaging. I also spent years fat from the endocrine problem (and getting medical abuse at the endocrinologist’s and elsewhere because I was, erm, fat from a medical problem), and wish I’d known about the FA movement then. I can’t not support it, and the idea of Health at Every Size. Everybody deserves respect.

ETA: I’m also angry that a major reason I have stayed with my current GP, in spite of his being hard of listening, is that the only weight-related comment he’s ever made in connection to my diabetes and back pain is “you look pretty fit”. Things are seriously wrong when this is so refreshing, and seems like the best you’re going to do overall.

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