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Here's why BMI measurements don't tell the whole story of your health

A high BMI is one of the underlying health conditions that can now qualify you for a vaccine in the DMV - but what does that number really mean?

WASHINGTON — A high BMI, or body mass index, is one of the underlying health conditions that can qualify you for a vaccine in D.C., Virginia, and now in Maryland. With about 40% of U.S. adults considered obese, how exactly do we use BMI measurements and obesity as a health indicator when it comes to COVID-19?

The Q&A Team at WUSA9 went to two local experts to find out everything you might not know about BMI.

QUESTION: Is BMI a true measure of health?

ANSWER: Turns out, the BMI measurement — a simple calculation based on weight and height — leaves a lot to be desired.

“BMI is a little better than looking at just weight alone. Even still, it's only an estimate,” Dr. Scott Kahan, Director of the National Center for Weight and Wellness, said. “It's a proxy of body fat percentage, and even that is only a proxy of what their health risk is, secondary to the weight.”

The CDC also speaks to the uses and shortcomings of the measurement, describing it as “an inexpensive and easy screening method for weight,” where the resulting score indicates a person is in one of four categories: underweight, healthy weight, overweight, and obese.

“BMI does not measure body fat directly, but BMI is moderately correlated with more direct measures of body fat,” it reads. “Furthermore, BMI appears to be as strongly correlated with various metabolic and disease outcomes as are these more direct measures of body fatness.”

RELATED: Maryland enters vaccine phase 2b Tuesday. Here's who is eligible

Q: What’s the back story of the BMI measurement and its creator?

A: The modern-day use of the BMI measurement comes along with a disturbing origin story and leaves lingering questions about how useful it is today. 

Psychotherapist and Professor at George Washington University Paula Atkinson teaches courses about “the myths of the U.S.'s measures of health, thin idealism, and society's relentless oppression of large bodies.” 

She considers BMI a “ridiculous” indicator of health. 

“It actually has an exceedingly racist history in that the guy who invented it did it to perform race science ... he was using the BMI to prove that thin white bodies are superior to larger brown bodies,” she explained. “It's a super racist, awful measure of health. And we're still using it.”

Atkinson referenced the Belgian mathematician, astronomer, sociologist and statistician Adolphe Quetelet, who first invented the BMI measurement nearly 200 years ago that is used today; originally known as the Quetelet Index until American physiologist Ancel Keys came up with the term Body Mass Index in 1972. 

Quetelet's initial findings have since been associated with eugenics: a racist method of seeking to improve humanity that was used throughout history, such as in Nazi Germany and throughout American slavery. 

Even in recent years, doctors, scientists and dietitians have expressed concerns over the shortcomings of BMI.

Q: So given that the measurement alone isn’t a one-size-fits-all health indicator, why should people with a high BMI still sign up to get the COVID-19 vaccine?

A: "We're not really talking about BMI, but rather we're talking about more broadly, whether meeting the clinical definition of obesity should be used as a condition that allows someone to have expedited access to the COVID vaccine," Dr. Kahan explained. "Everything that the studies show so far would support that."

Atkinson says it’s especially important since people with a higher BMI are often marginalized in our thin-centric society, even in health care. 

“I like that most people who happen to be in these categories are saying, you know what, I don't get anything for living in a big body in this culture. I might as well go get the vaccine. And I think that's great."

On social media, many have spoken up to share their plans to go get the vaccine because of a high BMI, encouraging others to join them, and not let shame or stigma get in their way. 

“I've seen a lot of people who are hesitant to take up a spot in getting a vaccine early, they feel like they've done this to themselves,” Dr. Kahan explained. “Although there is a volitional component, in terms of weight gain or weight loss, much of our body weights are outside of our direct control.”

Atkinson hopes people will keep that BMI number in perspective. “What we know is that your relationship with your body is the most important thing. If you suddenly think that now your body is inferior, you're not going to take good care of it. And that's the history of fatphobia,” she explained. 

“Please, Oh, please, please, don't let it affect your self-esteem. Don't let it affect your relationship with your body.”

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