Eating disorders can be dangerous and life-threatening. In fact, those suffering are not always underweight or even considered anorexic and many fall within normal weight ranges. This pulls the controversy of BMI equations under the spotlight to scrutinize its efficacy as a health measurement.
When Eating Disorders are discussed in the media a very particular image is portrayed of those suffering with eating disorders “Emaciated bodies are the typical image portrayed in the media of patients with restricting eating disorders such as anorexia.
The complications of malnutrition can occur at any weight,” as explained by lead researcher Melissa Whitelaw, a clinical specialist dietitian at The Royal Children's Hospital in Melbourne, Australia. It is not about the weight but the way in which weight is lost. (Pediatrics, 2014)
Anorexia is described as excessive weight loss which is caused by mental illness. It carries with it many psychological symptoms such as distorted self-image, depression, and fear of weight gain. This is one of the reasons why doctors are using BMI as an indicator for eating disorders. The BMI Index does not account for the fact muscle weighs more than fat or that someone could just be abnormally tall and not overweight. Equally, this does not account for any ethnicity that is not Caucasian. Overanalysing and criticising the body in an unhealthy way can occur when a person develops body image disorder. BMI leads as a reinforcer to this problem as it categorises people with inaccurate standards of measurement. If a person is ill informed, they may take the information and use it to confirm a fear of being overweight or being above the ‘normal’ category, leading to using the information as ammunition to rapidly and excessively lose weight in an unhealthy manner.
For many it is still unknown that you can be diagnosed with an eating disorder and still have a normal, or even high, body mass index, in fact many believe that BMI is an accurate health indicator to use when monitoring eating disorders. Many patients find it confusing and hard to accept a diagnosis of an eating disorder when their BMI is in the healthy range, “I’m just 5 foot tall. Despite losing 20% of my body weight, having a resting pulse of 40 beats/min, low blood pressure, and no periods for a year, my body mass index remained within the normal range at 19. If I had known that people can have anorexia but do not look like they do, maybe I would not have been so reluctant to accept I had it.” (BMJ, 2017) along with most the patient describes how they did not realise a diagnosis of an eating disorder can be made when categorised as ‘normal’ on the body mass index chart showing how an ‘inaccurate’ categorisation can have a negative impact.
BMI was first designed as a population measurement tool in 1832 and has long been used to define obesity, with increasing numbers of health and nutritional experts becoming increasingly critical of the approach. Does BMI paint a full picture of our health? No, seems to be the overriding opinion of experts. Is BMI a good health measure for eating disorders? A question we believe needs some very careful thought…. Do we need an alternative? Absolutely.
BMJ. (2017). I thought I wasn’t thin enough to be anorexic. Retrieved from BMJ: https://www.bmj.com/content/359/bmj.j5378
Pediatrics. (2014). Restrictive Eating Disorders Among Adolescent Inpatients. Pediatrics.