BMI part 3- the evidence against BMI

BMI part 3- the evidence against BMI

Hi everyone its Ali from Ok2BeFat
and it’s time for some fat activism basics. In this series of videos I’ll be
talking about BMI or the body mass index If you haven’t watched part 1 and 2 yet
I suggest you go back and watch them now so we’re all on the same page. Ready?
Great. This is part 3, the evidence against BMI. In this video I will be
discussing weight and weight loss. I will also be using the words obesity and
overweight in the context of discussing and quoting scientific studies even
though these are not words I would normally use. Before we start talking
about debunking BMI and the evidence against it, let’s make sure we all have
the same definitions. Epidemiology is the study of how often diseases occur in
different groups of people. When we discuss the scientific studies that are
supposed to show how many fat people are dying and what- the scientific field we
are talking about is epidemiology Epidemiologists research fatness by
comparing groups of fat people to groups of thin people and cataloging the
differences. These studies can give us correlations- which show that two things
may be connected- but they can’t show causation- which is that one thing causes
another. Linda Bacon gives a good example of this in Health at Every Size. Her
example is that balding men have been shown through epidemiology to have higher
rates of heart disease than men who haven’t lost their hair. Does this mean
that the amount of hair on your head protects you from heart disease? Is it
recommended that bald men gets toupees to reduce their risk of heart disease?
Not at all. Further research showed that higher levels of testosterone may be
causing both baldness and heart disease So when people talk about these studies,
it’s incredibly important to keep in mind the correlation does not equal
causation. Or that because A and B are happening at the same time that doesn’t
mean that A caused B B could be causing A or C and or D
could be causing them both. And studies that show correlation may not apply to
every individual person. Not everyone with high testosterone will lose their
hair or have heart disease, and while there are diseases that are associated
with fatness- an association doesn’t prove a cause. For example, in type 2
diabetes research shows that the insulin resistance that eventually develops into
type 2 diabetes may cause weight gain. Not that gaining weight causes insulin
resistance. People like to talk as though simply being fat caused heart disease or
diabetes but there are no diseases that can be attributed simply to fatness.
Because there are no diseases that only fat people get that then people don’t. In
addition, when discussing the rates of harm and death of fat people, we must
always keep in mind that fat people are pushed into high risk weight loss
methods including medication with harmful or deadly side effects and
dangerous and sometimes deadly surgery to mutilate their functional organs. The
cycle of repeatedly gaining and losing weight through yo-yo dieting is very
dangerous. Just one instance of losing and then gaining back weight can damage
blood vessels and increase the risk of cardiovascular disease. It’s also
important to keep in mind that fat people face significant medical
discrimination and that medical personnel have repeatedly shown very
high rates of both implicit and explicit anti fat bias. I’ve included two examples
of the many studies into the issue of rampant fat bias in medical personnel in
the sources list. One is called “Implicit anti-fat bias among health professionals: is anyone immune?” by B A Teachman and and K D Brownell and the other is “Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender” by Janice A. Sabin, Maddalena Marini, and Brian A. Nosek. I also suggest “First, Do No Harm- Real Stories of Fat Prejudice in Health Care”, a series of firsthand stories by
fat people of the prejudice and harm they face at the hands of the medical
profession. You can find a link in the source notes. When faced with humiliation,
scorn, and gatekeeping at the doctor’s office- many fat people choose not to go.
And when they do go they are often belittled, mocked, and denied care. Any study that discusses the health and mortality rates of fat people
that doesn’t take these factors into consideration is basically worthless. Now
that we’ve set up a proper framework let’s dig into the studies. In 2005,
epidemiologist Katherine Flegal published a study in the Journal of the
American Medical Association titled “Excess deaths associated with underweight, overweight, and obesity”. In this study, she confirmed what Ancel Keys
had found in the 1980s, that the risks of premature mortality associated with BMI
actually forms a u-shaped curve indicating increased risk for very
underweight people as well as very overweight people.
Additionally, where death rates did go up it wasn’t by much. In Harriet Brown’s book Body of Truth, Flegal called the differences “pretty tiny”.
This study was met with a complete uproar. The experts insisted there was no
way these results could be trusted, that Flegal’s work was poor. They accused her
of cherry-picking data. An epidemiologist from the University of Illinois-Chicago, S Jay Olshansky, replied to Flegal’s study with a journal article arguing that
rising rates of fatness would shorten overall lifespans by between 2 and 5
years. This was completely made up, as Olshansky’s co-author David Allison would
later admit to Scientific American saying the prediction was never meant to
be portrayed as precise. This kills me. Why did you have it published then, dude?
I guess because fear-mongering is profitable? So Flegal takes a look at
the uproar and the criticism and decides to rebut it by spending the next 8
years collecting information about 97 different studies on weight and
premature mortality. The results of this meta-analysis, which was published in
2013 and included results from over two point eight eight million people were
exactly the same as the results of the 2005 study. Being fat does not put a
person at greater risk of dying and even being very fat only increases the
chances slightly. This second study provoked another round of denial and
uproar. One of Flegal’s loudest critics has been Walter Willett, a nutritionist
and professor at Harvard. He even organized a conference at Harvard solely
to attack her work. Selectively choosing which data to include is Willett’s
criticism of Flegal, which is funny since the 2010 study that he published- the one
that found early mortality risks the lowest among people with a so-called
‘normal’ BMI- that study threw out over 80% of the data to get to that status quo
upholding result. He deleted anyone who had ever smoked or had a history of
cancer or heart disease. So who picked the cherries here exactly I guess we’ll
never know. Oh look I’ve died from sarcasm poisoning. In his book The Obesity Myth, Paul Campos discusses another famous study that is supposed to
prove that a higher BMI leads to higher premature mortality. The Nurses Health
Study was published in the New England Journal of Medicine under the title “Body Weight and Mortality Among Women”. It followed one hundred and fifteen
thousand nurses for sixteen years and although this study is citing constantly
as proof that fatness kills, it has major flaws.
For one thing only 4700 women died during this time period out of 115
thousand or only 4.5% of the group. This is not a very large number of deaths and
not really a percentage that should allow people to feel confident making
sweeping statements about so-called excess weight being a danger to all
people everywhere. Ninety-eight percent of this group of nurses was middle-aged,
middle class white American women, so maybe the safest thing we can say about
this study is that middle-class white women have a really low overall
mortality rate when they are middle-aged We could also safely say that smoking is
a serious health hazard, as the death rate was significantly higher among
smokers. Because the thinnest women were nearly twice as likely to smoke as the
fattest woman we could perhaps even say that wanting to stay thin is a risk
factor for smoking. A side note- I am an ex-smoker
and I don’t like the demonizing of smokers that you see basically
everywhere, so let’s lay off turning people who smoke into demons. Rates of
smoking are higher among marginalised groups and quitting is a painful daily
agony with very little in the way of support. Smoking is legitimately bad for
you but so is playing football or driving a car. I will not turn one group
of people into monsters to save another People are people and we’re all doing
the best we can, so let’s not go there okay? Great, thank you. Back to Campos. The
authors of the Nurses Health Study use percentages in misleading ways. To give
an analogy of the way the data was manipulated consider this example- if an
overall 2% risk of rain is doubled to 4% that’s still quite a small chance that
it will rain you can either report an overall 2% increase in risk or you can
say the risk went up by 200%. Both are factually accurate but the second one
looks much scarier and bigger simply because 200 is a bigger number. If
you take out such manipulations of data the Nurses Health Study actually finds
the women with the lowest risk of death are a lot larger than average. And yet the
authors of this study claimed that being even mildly overweight is associated
with a substantial increase in premature death- a conclusion which their own study
does not support. This disconnect between the data and the conclusions of a study
are very common in studies that are supposed to prove negative claims
against fat people. When you take these fatphobic study conclusions, turn them
into a press release that you run through the media machine of science
reporters who report only screaming headlines- you add more stigma to a world
that never stops harming and stigmatizing fat people. Let’s add a few
more studies, a bit more research for the But Science! crowd, just to make sure that
we all know that studies debunking BMI and lifespan are very widespread. In Health at Every Size, Linda Bacon lists the following studies that show that fat
people were living as long as and frequently longer than so-called normal
weight people. The Established Populations for the Epidemiological Studies of the Elderly investigation which included more than 8,000 senior
citizens. The Study of Osteoporotic Fractures investigation which included
more than 8,000 women. The Cardiovascular Health Study which included almost 5,000
people. The Women’s Health Initiative Observational Study which included
90,000 women. A study of almost 170,000 people in China. A study of 20,000 German
construction workers. A study of 12,000 Finnish women. A study of 1.7 million
Norwegians, which found the lowest life expectancy among those defined by BMI as
underweight. And what is the scientific community done when faced with this
research? They label it a paradox and ignore it. They keep pushing outdated
information. They actively work to keep the stigma against
fat people in place- a stigma that ruins lives. Because supporting the status quo
is easy. And because that’s how so many of them get paid.
Harriet Brown says says in Body of Truth- “I’ve been told by numerous researchers that the easiest way to get a study funded now is to include the
word obesity in the proposal. Even better cite childhood obesity.” So when faced with
the question- why do we keep using BMI as a measurement of health when we know it
doesn’t measure health at all- I think the answer is clear. BMI does actually do
what it’s supposed to do It’s just that what it’s supposed to do
has nothing to do with health. BMI is a way to excuse the bigotry that is
fatphobia. BMI gives fatphobia rules. It makes hating fat people easy and
bloodless. It keeps the worst and most deadly discrimination that we face-
medical discrimination- it keeps that discrimination discreet and private and
hard to talk about or to prove BMI gives a culture that hates and fears
fatness a science-y sounding basis to keep hating and fearing fat people. To keep
hating and punishing the fat people that thin people are afraid that they are
going to become. BMI makes stigmatizing fat people easy. It uses math and round
numbers to put a little distance between the fatphobic person and the fat person
that they are harming. BMI makes a fat person into a number, a medical problem, a
disease that must be stopped by stripping fat people of our status as
people and replacing our humanity with a moral indictment in the form of an
equation BMI props up the weight loss industry, a
harmful and useless industry that extracts sixty billion dollars a year
out of the economy of the United States Money that it would not be possible to
make without fat stigma. Money that could be put to a better use doing almost
anything else The
profits of this agony machine are increased by increasing the pain and
fear and deaths of fat people BMI makes hatred into math. And people
feel comforted in their prejudice by having that math, and some people make
obscene amounts of money from it and so it remains. But it doesn’t have
anything to do with health and it never did. And that’s the end of part 3. And
that’s the end of the BMI series. Please see the notes for a list of the sources
I consulted for this series. If you have specific questions about BMI, leave a
comment below. Always and forever, I have to thank all the fat activists who came
before me and all those who came after and thank you also to my supporters on
Patreon especially the ones scrolling by now. you can support my work on Patreon
at Your support helps me continue this work. See
you again soon.

7 thoughts on “BMI part 3- the evidence against BMI

  1. Thank you so much for this, for all the work you've done and all the information you've sifted through. I'm so glad that I'll be able to have these videos to point people towards if they want an accessible explanation of the BMI and why it's absurd and why that matters. You're amazing!

  2. Thank you so much for all the work you've done! Some of my most traumatic memories are of doctors offices and little dots on a graph and the doctor acting like my life was over. Good to know and have proof that it's all bullshit.

  3. Wow 😲. First off bmi is just a measurement that's all. Like a scale. Yes it doesn't put muscle into consideration or race. It does do gender. It may seem out dated to you but it's one of the only things that we have right now, and it is not always wrong. Which is why a good physician will take into account your daily activities, and the way you consume food along with just being honest.
    I have been through several doctors who my whole life have told me I'm obese, and i have asked what i should do? They always state get on a diet. Which i do and or always fall through. It wasn't until my obgyn who is a very small woman stated that i needed to loose weight, because then i was 410 pounds. At my heaviest! To which it was making my hormones go waky, but in that she didn't suggest a diet but a life change. Which is change the way you eat and get healthy by doing more activities. She even stated that she loves food, but does things in moderation since diets are just temporary to get towards a goal weight. At first i didn't understand and treated it as a diet, and it fell through but i didn't gain nor lost weight. Not until last year when i started my health change in October, and started to teach myself to eat healthy. I didn't start exercising until February, because i was losing some inches and gaining some loose skin. I'm only at 380, but am toning down getting muscles 💪. I still have a long way to go, but i and to be fit and healthy. I don't care about being skinny, and i want to complety not be dependent on a back brace. Which i have been using it for three years on and off after the first year and a half. I don't really use it now since I've been exercising, but i still sit when i wash dishes though on the cooking side not so much! These are my goals and if it wasn't for the bmi and my obgyn and my husband support i wouldn't be getting healthy at all! Even with my back hurting as it was, and then my independence would have been taken away.
    Everyone can have unhealthy fat that's a given, but you shouldn't be mad at an estimated tool either. Science has its ups and downs, but to be honest obesity is on the rise. Along with many people who are claiming disability because of their obesity; For the fact that they can't move so now society is taking care of them, and I'm not talking about the people who have a health disease, disability, or mental disorders. Also no I'm not saying that thin people don't have risks either, because they still have fat with no muscle alot of the time. Which is just a skinny fat
    Just on a smaller scale is all. To which a physician will point out that they need to get healthy also, and not these physicians who don't do their job and are prejudice towards body size. To which you can always fire your physician and get another one. You don't necessarily have to stick with a physician that is like that…

  4. Great research! The scientific establishment is being revealed to be propagating lies in the name of truth and knowledge. They have successfully recruited women to enforce their own misogynist agenda.

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