Opinion: Fat and body mass index are not adequate indicators of health or beauty

This post was updated May 16 at 6:49 p.m.

Each year, the fashion, media and health industries find new ways to prey on the insecurities of women by perpetuating fatphobia.

Setting and idealizing unobtainable body standards only exacerbate women’s physical and mental stress. These industries further “fatphobia,” or the discrimination and hatred of people with visible body fat, by equating fatness with inferiority and ugliness. As consumers, we have internalized the idea that those who are size 0 or low in body fat are more aesthetically pleasing and healthier than those who are not.

However, a simple calculation of body mass index is unable to distinguish fat from muscle mass, nor does it give any true insight into disease, according to researchers at the University of Pennsylvania.

In fact, a recent UCLA study found a 42% decrease in mortality from heart disease in women who had high percentages of both body fat and muscle mass compared to those with low muscle mass and body fat. There was only a 26% decrease in mortality from heart disease in men with the same conditions.

In contrast, women with high muscle mass and low body fat did not demonstrate a lower chance of death from heart disease. The same can’t be said of men. Researchers found a 60% decrease in likelihood of death from heart disease in men with high muscle mass and low body fat.

This study ultimately suggests a sexual dimorphism in cardiovascular disease and highlights the importance of viewing fat and muscle differently between sexes.

With this data in mind, we must deconstruct our preconceived notions regarding body weight, since women with high body fat and muscle mass, and thus a higher weight, are actually less inclined to develop heart disease. But in order to do so, we must eliminate society’s obsession with women’s bodies, their weight and their body fat.

Dr. Preethi Srikanthan, an endocrinologist at UCLA and first author of the study, said weight loss as a diagnosis is a gross simplification of health messaging.

“When we talk about losing weight, we lose everything. We lose fat. We lose muscle,” Srikanthan said. “(In our research, we found) an increase in fat mass in the presence of increased muscle mass appeared to benefit women with the end outcome of cardiovascular mortality.”

And we certainly cannot evaluate fat without considering sex. Women tend to retain a greater amount of brown adipose tissue as they grow older and tend to carry fat in different places than men, Srikanthan added.

Moreover, we cannot ignore how body weight has become the scapegoat diagnosis when women seek medical attention.

Dr. Tamara Horwich, a health sciences associate clinical professor of cardiology at the David Geffen School of Medicine, cardiologist and co-author of the aforementioned study, said every time a doctor recommends a woman lose weight, they could be causing more harm than good.

“(BMI) should not be what we use to tell our patients to lose weight,” Horwich said. “Getting on a scale doesn’t tell you anything about how much your bones weigh or your muscles. It’s just one number.”

Somewhere along the way, we started confusing body weight for an accurate measure of health. With new research findings and advice from experts, we must deconstruct this notion.

And the discussion of weight extends beyond the doctor’s office – it branches into the fashion and media industries in ways that unknowingly make us obsessed with physical appearance. While patients and consumers have everything to lose, the industries that profit from fatphobia have a lot to gain.

Sameepya Thatipelli, a fourth-year psychobiology student, said it is important not to support brands that perpetuate fatphobia, like Brandy Melville, which offers mostly one size of clothing.

“I feel like a lot of companies aren’t aware about how their sizing affects how a lot of young women perceive themselves,” Thatipelli said.

When young girls grow up surrounded by industries that tell them their body should appear a certain way or that certain bodies are normal, it is no surprise that unhealthy obsessions with body fat and diet restriction carry into womanhood.

So, as a community that values the health and well-being of women, we must alter our beliefs about the meaning of weight, since clearly, the culture that equates body weight to overall health is extremely flawed. It can start with promoting holistic, intuitive eating rather than restrictive dieting, and being size inclusive.

However, the motion to decentralize BMI as a means of measuring health is not to be misconstrued. Acknowledging that weight, on its own, is not a good measure of health is a promising first step, but it does not mean that people should eat large quantities of processed food, quit exercising or discard their motivation to lead healthy lives. Ultimately, our goal should be to halt the obsession with body weight and refocus on healthy eating, holistic habits and preservation of muscle mass without the scale in mind.

“Live healthfully but don’t become obsessed with one particular idea, which is this concept of weight,” Srikanthan said.

We all would do well to remember this advice.