When trying to find your spot for the COVID-19 vaccine, the best thing to do is calculate your BMI. The abbreviation for Body Mass Index is used by the Centers for Disease Control and Prevention to define obesity, one of the underlying medical conditions that are at higher risk of complications from COVID-19. Under Washington’s vaccine rollout plan, anyone over 16 who has at least two underlying conditions – a BMI greater than 30 would count – is eligible for Phase 1B, Tier 3, which is expected to begin in the spring or summer.
But what does the BMI really tell us? Alone not as much as you might think.
The index was developed in 1832 by the Belgian mathematician and sociologist Adolphe Quetelet and is a mathematical formula that was later revised by Ancel Keys in 1972 and referred to as the body mass index. Nearly 200 years old, the index is still widely used by health systems and governments today because it is an inexpensive and simple tool.
The formula gives a person’s weight in kilograms divided by the square of the height in meters. (Not a mathematician? There are many BMI calculators online, including on the CDC website.)
According to the CDC in 2019, 28 percent of Washingtoners were obese. If they also have another disease, they will have access to the COVID-19 vaccine in front of the general population. Some states have offered people vaccines based solely on a high BMI.
A high BMI can be an indicator of a body fat percentage that puts a person at risk for diabetes, high blood pressure, stroke, and a number of other conditions.
The key word: can.
“Bigger Body, But Not Obese”
A growing movement denies that BMI is correlated with health and advocates that people, no matter their size, should love their bodies.
In a recent Instagram post, pop star Lizzo stands in front of a mirror, rubbing her stomach and talking to him.
“I love you so much. I love you so much,” she said in a video posted to her 9.8 million followers (username: lizzobeeating). “Thank you for making me happy that you are me kept alive. “
The nearly 3 million view caption told the audience that she recently started talking to her stomach and praising it after previously “cutting my stomach off, I hated it so much”.
Lizzo, 32, has become an icon for people following the movement of body positivity that contradicts the belief that healthy means thin.
“I think there is a lot of positive news, like from Lizzo,” said Kaiser Permanente-registered nutritionist Kerry Martinson. “Everyone cannot be the same shape. It’s more about your life. Eat healthy? How is your stress How is your activity The BMI does not take into account muscle or bone density. “
She pointed to one of the most famous examples of erroneous BMI: the BMI of actor and former California Governor Arnold Schwarzenegger was measured in the 1930s during his bodybuilding career. Many athletes have a high body mass index.
“You can have a bigger body, but you can’t be obese,” said Karen Kennedy, a local certified nutritionist. “Obesity creates a metabolic health crisis and a whole host of other problems. But being a tall person isn’t bad. “
A “blunt instrument”
Although the BMI is an incomplete metric, experts are unwilling to erase the index entirely.
It’s a “blunt tool,” but still a useful screening tool for population-level interpretation, said Melissa Martin, program manager for chronic disease prevention at Clark County Public Health. Obesity data comes mainly from self-reporting at national level. For Martin, the information helps identify geographic areas that need attention. Studies have shown that people of skin color and low-income families are at higher risk of obesity than other groups.
“How we use (the BMI) is more to look at areas of the county where we want to focus and find ways to find community-led solutions,” she said.
Many doctors and other health care providers consider BMI when assessing individual health. A diagnosis of obesity is often why doctors refer patients to a nutritionist such as Martinson.
“People see the term ‘obese’ and it can be very negative and it can make people feel bad,” Martinson said. “I try to be sensitive to it when I see someone. When it comes up, I don’t focus on it. When they ask, I try to remind them that you can be healthy and be in a larger body, beyond what is given in the medical table, just to look at the whole picture, not just a number. “
Kennedy has learned from some of her clients that the BMI often urges doctors to offer too simple a solution: get fit.
“The health problems can be dismissed as ‘you just have to lose some weight’,” she said. “And don’t look at what could possibly be causing this weight gain. … Instead of looking at weight as the cause of everything, you could look at it as a symptom of an underlying imbalance. “
Obesity puts you at risk of serious illness, according to the CDC. But maybe, Martinson said, the BMI itself shouldn’t be that much weight. As a nutritionist, Martinson tends to consider how weight is supported.
“If you have your weight in your hips and legs rather than your stomach, that’s the pear shape and that weight is less of a risk factor,” she said. “But when you have your weight around your stomach – the apple shape – you are at greater risk. Your actual health is improved through things like exercise and muscle building. “
And if a high BMI helps people gain access to a COVID-19 vaccine, Martinson is okay with that.
“It would certainly open it up to a large number of people,” she said. “That can be an asset to someone who is defined as obese. I will vote for it. ”