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In other words, athletes who have a lot of muscle are more likely to have a higher weight, which BMI mistakes as a higher body fat range. In some people, such as older people who lose muscle mass, or thin people with very little muscle mass, BMI can underestimate body fat.
The limitations of BMI go beyond not figuring muscle and physical fitness into the equation, though. It further stigmatizes patients — especially obese patients — who do not fall into a “normal” BMI category and can keep those who may need medical health the most, including to lose weight, out of their doctors’ offices by unfairly increasing their insurance premiums.
BMI Problems: Dismissing Health Conditions Because of BMI
When Bee, 32, of Sacramento, California went in to see her doctor this year, she found that her BMI was the start and endpoint of the conversation. “The doctor used weight as an excuse for everything and didn’t look further,” she said.
“They brushed off many concerns with the excuse of weight. I had what I’m pretty sure was a false negative COVID test this summer and they kept just saying my weight was affecting my asthma (which I didn’t even have to any sort of extreme beforehand), even though I’d actually recently lost 20 pounds. It was humiliating, defeating, demeaning, dehumanizing and quite terrifying while I was so sick to be dismissed so quickly because of my BMI.”
Bee, who has Polycystic Ovarian Syndrome (PCOS), said that her doctor won’t even further investigate the condition as a result of her BMI. “The only recommendations they’ll give me for PCOS is for me to lose weight and take birth control.”
According to Sasha Ottey MHA, MT (ASCP), Executive Director of PCOS Challenge at The National Polycystic Ovary Syndrome Association, this weight bias is all too common and highly reductive, considering many patients do have a weight loss plan or eat well and exercise, yet still deal with PCOS and other endocrine conditions.