THE PERFECT WEIGHT?

Why relying on body-mass index can sometimes be a big problem

The question sounds simple but is a complicated answer: How much should I weigh? You may have heard that the best way to assess your proper weight is by looking at body-mass index (BMI), which correlates your height and weight into health ranges. While this is a starting place it is certainly not the end-all-be-all.

Here are two examples of clients in my practice that used BMI to assess how much they should weigh and the challenges that arose because of this.

Melanie, a 55-year-old menopausal woman had lost and gained the same 50 pounds over the years. She had high blood pressure and suffered from depression. At five-foot-four and 230 pounds, her BMI labelled her obese. This five-letter word was deflating. After years of trying to achieve a healthy BMI range of 108 to 145 pounds with no success, Melanie decided to let it go. Looking back at her history it became clear that even when she was eating and exercising almost perfectly she was never able to nudge lower than 170 pounds. Over time Melanie found peace with her weight and successfully now maintains a weight of 175 to 185 pounds. Despite BMI still classifying her as obese, she has more fun, better flexibility with her food, lowered knee pain and has dropped her blood pressure.

At 16, Beth remembers feeling bigger than most girls in her class. At fivefoot-six and 170 pounds she started dieting and exercising excessively. She got to 120 pounds by being severely bulimic. At 19, a well-intended health professional that didn’t know the punishing regime Beth had been following for years, suggested that she was at a good weight because she fell within the healthy BMI range. Her psychologist and I had to work very hard to convince her that 120 pounds, although considered healthy by the BMI, was not healthy for her. As Beth recovered from her disorder and began to nourish her body with sufficient food and moderate activity, the scale normalized to the higher end of the BMI range. Her blood pressure and heart rate improved and her menstrual cycle reappeared. While happy that her physical health was restored, Beth still struggles with knowing that while some women at her height can be healthy at 115 pounds, in order to be healthy she needs to weigh almost 40 pounds more.