NYT’s Alice Callahan Ignores Benefits of BMI for Healthy Living
- Dangers of obesity downplayed in favor of body positivity
- “Weight stigma” is harmful and unhealthy according to writer, so BMI is dismissed as useful screening method because it has limitations
- Callahan uses red herrings and extreme expert views to present an unbalanced picture of the medical use of BMI
- Callahan promotes pro-fat death cult in lieu of getting healthy
OUR RATING: Major Negligence. MSNBC-level basic journalistic negligence.
Alice Callahan seeks to normalize obesity by using the extreme views of certain “experts” and by making the assumption that BMI is the only tool doctors use. This is false. BMI is one kind of useful screening tool for doctors that, along with other methods and variables, is used to gauge the different risks each individual might face.
- Bad Source
- Red Herring
Callahan first begins by stating the BMI method:
“Its formula is simple: Take your weight (in kilograms), and divide by the square of your height (in meters). The result, which slots you into one of four main categories, is meant to describe your body in a single word or two: underweight (B.M.I. less than 18.5), normal weight (18.5 to 24.9), overweight (25.0 to 29.9) or obese (30 or greater).”
The primary thrust of Callahan’s article is that BMI is not a good indicator of a healthy weight, and that many people could be adversely affected by being told they are obese or overweight. But she ignores the effectiveness of BMI as being one way of measuring health.
Instead of giving both sides of the argument for BMI, she goes all in on the negative psychological effects caused by the method:
“Many feel judged by these categories, given that only about a quarter of adults in the United States can call themselves “normal” on the B.M.I. scale.”
Thus, BMI is, in fact, a scam:
“For all its utility as a research tool, though, body mass index is “fairly useless when looking at the individual,” said Dr. Yoni Freedhoff, an associate professor of family medicine at the University of Ottawa.”
Callahan inflates the limitations posed by BMI. Her article is very unbalanced. She tells everyone what they’ve already heard from doctors:
“B.M.I. can’t tell, for instance, what percentage of a person’s weight is from their fat, muscle or bone. This explains why muscular athletes often have high B.M.I.s despite having little body fat.”
This is a biased and unbalanced representation of the traditional argument for BMI. According to Robert H. Shmerling MD, Senior Faculty Editor at Harvard Health Publishing  :
In general, the higher your BMI, the higher the risk of developing a range of conditions linked with excess weight, including diabetes, arthritis, liver disease, several types of cancer (such as those of the breast, colon, and prostate), high blood pressure (hypertension), high cholesterol, and sleep apnea.”
The bottom line, according to Shmerling, is this:
“As a single measure, BMI is clearly not a perfect measure of health. But it’s still a useful starting point for important conditions that become more likely when a person is overweight or obese. In my view, it’s a good idea to know your BMI. But it’s also important to recognize its limitations.”
Not only does a well-published Harvard doctor establish BMI as a useful screening method, but BMI and waist measurement are used to determine obesity by “essentially all major national and international health organizations, including the American College of Sports Medicine (ACSM), American College of Cardiology (ACC), Centers for Disease Control and Prevention, The Obesity Society (TOS), and the American Heart Association (AHA).” 
Furthermore, according to a study published in the ACSM Health and Fitness Journal:
The 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults reported that there is a direct dose-response relationship between BMI and the risk of fatal and nonfatal disorders (9). For example, an increase in BMI of 1 kg/m2 more than 22 kg/m2 was associated with a 10% increase in coronary heart disease (11). Furthermore, Wolf and Colditz found that obese individuals with a BMI of 35 kg/m2 or higher had a 42-fold greater risk for developing type II diabetes, and those with a BMI of 40 kg/m2 or higher had a 53-fold greater risk than those of normal weight status (18.5 to 24.9 kg/m2) (22).” 
But we hear only limitations from Callahan, which distorts the issue she is attempting to investigate.
The second problem is that Callahan uses a red herring: she acts as though there are just huge populations of doctors who use only BMI as an indicator of health:
“…if the doctors of patients with higher B.M.I.s focus on weight alone as the cause of any health issues they may have, the doctors may miss more important diagnoses and risk stigmatizing patients.”
Where are these doctors? Can she give real examples of this actually happening? Probably not, because the majority of doctors take into account blood pressure, cholesterol and other lifestyle choices such as diet, sleep, and exercise to determine a person’s risk .
David Brewer, a registered dietician in Central Ohio, said much the same in an email:
“Yes, that is accurate that other factors are taken into consideration. BMI is also a generally accurate tool for predicting “will weight loss improve this person’s health?” We can argue the nuance that it doesn’t apply for bodybuilders and athletes (although most athletes with a BMI>30 probably would be healthier with a little weight loss even if their exercise level makes them healthier than non-exercising average Joe) and that there are people at a “healthy BMI” who are overall unhealthy.”
Callahan’s third problem is that she creates a narrative on the basis of a few experts who claim that most doctors are biased against fat patients, so they use BMI to shame them, which then causes their patients to gain even more weight because they are ashamed. Here’s how Callahan phrases it:
“There is plenty of evidence that weight stigma is harmful, Dr. Tomiyama said. Research has shown that anti-fat bias is common among medical doctors, which can result in lower quality care and cause patients to avoid or delay medical attention. People who have felt discriminated against because of heavier weight are also about 2.5 times more likely to have mood or anxiety disorders, and are more likely to gain weight and have a shorter life expectancy.”
“Dr. Strings argued that focusing on body mass index as a measure of health only distracts from the more important work of addressing the structural factors that lead to poor health, like “poverty, racism, lack of access to healthy fruits and vegetables” and environmental toxins, she said. “But instead, we just keep wanting to vilify fat people.”
So, is Callahan advising doctors to ask their obese patients if they’ve experienced racism lately rather than focus on their BMI? Callahan mentions that black women, as a group, often have the highest BMIs which is a “burden” that falls on them to lose weight. This is part of the obesity myth that racism causes obesity.
Further, is it really the best method for doctors to advise their patients that their best weight is their “healthy, happy weight,” as one of Callahan’s sources calls it?
Callahan pushes a common obesity myth in her article when she writes that “People who have felt discriminated against because of heavier weight…are more likely to gain weight and have a shorter life expectancy.” In reality, “Some data points out that people achieve more by setting more challenging goals,” according to MedicalNewsToday .
According to the New England Journal of Medicine:
“Empirical data indicate no consistent negative association between ambitious goals and program completion or weight loss. Indeed, several studies have shown that more ambitious goals are sometimes associated with better weight-loss outcomes” .
One comment from a bariatric surgeon below this article can also help answer this question:
“The evidence suggests that prolonged exposure to obesity tightens its association with developing these medical issues over time, i.e. an obese individual may be metabolically normal today, but they are less and less likely to remain healthy with every passing year…Do we advocate that patients enjoy their ‘best weight’ knowing this is a risk factor for developing hypertension, hyperlipidemia, diabetes, sleep apnea, cancer, and debilitating musculoskeletal issues? Do we tell them not to worry as they are healthy today, knowing they are at elevated risk of problems tomorrow? My point: this is just like telling a smoker “don’t worry, most 41 year old smokers don’t have cancer today” The issue of course is the risk to your future self, not the immediate link to any diagnosis” .
Callahan ignores the long term dangers of avoiding screening tools that might alert doctors to the potential problems a person might face in the future due to an overweight BMI. This is all part of the body positivity movement in vogue with left-wing elites, which is often directly in contrast to basic medical opinion. No one is arguing BMI is a perfect measurement and decisions should be made on that basis alone. She ultimately engages a red herring rather than a serious argument for BMI, and on that basis erroneously calls it a scam.
OUR RATING = Major Negligence. MSNBC-level basic journalistic negligence
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