This is why BMI is a faulty measurement, according to a PT
I have never felt healthier. After a really tough period for my mental health last year, I've managed to put my health first and rebuild the basics of my sleep, nutrition, stress management and exercise, and now I am functioning at my optimum.
How do I know that? I know that because of the energy that I have available to me each day. I know that because when I journal, I'm optimistic, positive and enthusiastic. I know because I can deal with the tough moments in life without feeling completely overwhelmed. I know because my resting heart rate is pretty low, in high 40s. I know because I can run far and well and work on my cardiovascular fitness regularly. I know because I'm strong and I'm getting ready to compete in weightlifting.
What I don't rely on to tell me about my health is my BMI or my weight. In fact, if I followed that metric, I'd be worried. As a short woman weighing 63 kilos, my BMI tells me I'm overweight. In fact, when I competed at in my last weightlifting competition in December, weighing slightly more than I do now, I would have been very overweight.
Why BMI should not be used in isolation
While conversations around the efficacy of BMI have long been ongoing (it was never actually intended to be a measure of health, after all), this week, a report found that the use of the term 'obesity' was flawed. Experts writing in The Lancet stated that the term should be fit into two categories: 'clinical obesity', used for patients with a medical condition caused by their weight, and 'pre-clinically obese', for those who are in larger bodies but still fit.
I completely agree that the way we categorise weight and use it as a health metric is flawed. It's not that I disagree with BMI as a tool, just that I disagree with it being used in isolation.
We need to think about weight in context. Muscle is so important for our health. It protects our joints, metabolism, cognition and quality of life. But there's a stigma attached to having too much of it, largely because we've always been told being smaller is healthier and muscle mass adds size.
Women are being made to fear muscle gain
I am really lucky that I haven't had negative experiences with doctors as a result of my weight. I think that's because I look visibly muscular, which means a doctor can tell my weight is as a result of a healthy lifestyle. However, after I went on TV to discuss my take on the new report, I was flooded with hugely concerning messages from women about how their weight has impacted their treatment.
One of them was a 60-year-old woman who trains at a gym I work in. They lift weights regularly and have even competed in Strong Woman competitions. Right now, they're waiting for an operation but their doctor has told them they can't have it until they reach a certain BMI. [This because there can be a higher risk of complications with anaesthetic and recovery among those with higher BMI's.]
She's lost five kilos, but she has access to a biometric scanner that shows all of that weight has been muscle mass. She's told me she doesn't want to come to the gym at the moment because she might add on some muscle, put the scale weight up and be screwed.
It's concerning. As a 60-year-old, regaining that muscle again will be difficult, let alone regaining it after surgery when you may not be as mobile. Sarcopenia is a real issue and leads to degenerated muscle mass as we age, so losing muscle at that time in life will have a huge impact on her overall health.
Smaller does not automatically mean healthier
Yet, she won't be the first person I know who's avoided the weights room for fear of their weight. I've seen all too often people start strength training and get annoyed when they gain weight. There's a real emotional struggle with that. The average person can get be upset that they've done all this hard work in the gym and the scales are going the wrong way. It makes sense, given women in particular have spent their entire lives being told that thinness and being light is to be celebrated.
I've been there. Around 15 years ago, I decided to run a marathon on the basis that it would make me thin, which would make me acceptable. I got to my goal weight – and I've never felt so crap. It was a hard realisation that being smaller didn't make me happier or healthier. In fact, it was probably the most unhealthy I've ever been.
Now, in a more athletic body, I'm about to enter another weightlifting competition and I'm ready to PB all of my lifts (that would mean beating my current records of a 56kg snatch and 73kg clean and jerk). Hopefully, everyone can see that makes me pretty fit and strong regardless of my size.
What needs to be done?
I truly believe a tide change is coming on weight, but it requires us to re-learn a lot about the true markers of health.
What's even more useful than knowing how many kilos you are is understanding the body composition behind the weight. So, do you have enough muscle to support your activities? Do you have enough fat to regulate your hormones but not too much that it impacts your health, and ideally not around your organs?
While we can't do a blood test on ourselves at home, we can easily measure our heart rate and keep on top of our blood pressure. And we can check in ourselves to create a strong relationship with our bodies, asking how we're feeling, how's our sleep and how much energy we have. Those things tell us so much more than our BMI.
More like this:
What is BMR? Why your basal metabolic rate matters (and how to calculate it!)
TDEE: a complete guide to calculating your total daily energy expenditure
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