Gutin 2018 Soc Theory Health

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Gutin I (2018) In BMI we trust: reframing the body mass index as a measure of health. Soc Theory Health 16:256–71.

» PMID: 31007613 Open Access

Gutin I (2018) Soc Theory Health

Abstract: Recent work in medical sociology has provided critical insights into distinguishing between obesity as a condition with severe individual- and population-level health consequences, and obesity as a socially undesirable, stigmatizing construct opposing thinness as the healthy ideal. Less often considered is the role of Body Mass Index (BMI) as the standard by which obesity and healthy weight are measured and defined. Addressing this issue, I begin by distinguishing between BMI as an empirical, objective measure of health, and BMI as an arbitrary, subjective label for categorizing the population. I further consider how BMI is empowered as a measurable quantity through the lens of medicalization and evidence-based medicine, and introduce the "performativity" of BMI as a superior framework for confronting the measure's conceptual limitations. Emphasizing key parallels between BMI and self-rated health as measures with high predictive validity, yet unspecified mechanisms of action, I propose an epistemological shift away from classifying BMI as a biomarker and toward a more flexible view of the measure as a holistic appraisal of health. In closing, I argue that researchers may continue to leverage BMI's ease of collection and interpretation, provided they are attuned to its definitional ambiguity across diverse research methods and contexts.

Bioblast editor: Gnaiger E

» BME and mitObesity news (2020-02-14)
  • 'Individuals are labelled obese, overweight, and normal weight based on their BMI potentially ignoring its limited accuracy in mapping weight to health risk.'
  • '.. at the population level, the U.S. Department of Health and Human Services gradually shifted towards a lower BMI cut-off for “overweight” in the 1990s (from ≥27.8 for men and ≥27.3 for women in Healthy People 2000 [1990], to >25.0 for both in the 4th edition of Dietary Guidelines [1995]) redefining ~30–40 million Americans as “unhealthy” (Kuczmarski and Flegal 2000).'
  • 'Given its definitional arbitrariness, in using BMI we can only draw conclusions about BMI itself, limiting our capacity to understand the relationship between weight and health; i.e. the ‘real’ phenomena that BMI seeks to model.'
  • 'While body fat percentage, skinfolds, and/or waist circumference can help provide a better measure of individuals’ adiposity, BMI continues to be the primary measure given its ease and low cost of collection (Burkhauser and Cawley, 2008).'
  • 'The robustness of the BMI-mortality relationship reflects the numerous health conditions and co-morbidities associated with an elevated BMI.'
  • 'BMI has helped define the obesity epidemic due to its ease of collection, analysis, and interpretation by scientists and the public.'

Labels: Pathology: Obesity 

Organism: Human 

Preparation: Intact organism 

BMI, mitObesity2020