Saturday, February 6, 2016

Nothing more than fat hatred

For several years my health insurance has demanded I see my doctor for a checkup, including recording my weight. From the scale and height my Body Max Index is computed. If my BMI is in the "obese" range my health insurer demands I go on a diet. If my BMI says I'm merely "overweight" then no diet is necessary. Most of the time I'm just above that division. Last year was the first time I was under it. That means I don't have to see my doctor for a checkup this winter – which is good because my BMI is high again.

One year I was offered the alternative of wearing a pedometer and uploading my number of steps per day. I called them and said I frequently ride my bicycle and I'm sure I get a much more strenuous workout on that than I would by walking. Could I do that instead? The answer: no, we're unable to verify it. So to satisfy their bean counters I would have had to reduce my level of exercise. I chose the diet. Which didn't work.

The form the insurance company requires my doctor to fill out also includes such things as smoking (never), alcohol consumption (I don't), cholesterol (safe range), blood pressure (within limits). The only thing the insurance company objects to is the BMI.

Researchers in Calif. have looked at BMI, blood pressure, blood sugar, cholesterol, and several other cardiometabolic assessments. All those tests (except BMI) can give an accurate measure of heart and overall health. The research found that BMI doesn't correlate with them. That means BMI had nothing to do with heart health.

So 54 million people are labeled as unhealthy and pushed into treatment they don't need and sometimes charged higher health insurance premiums. And another huge number of people (don't have exact numbers) who have a great BMI yet are actually not healthy.

This matters because the EEOC has proposed a rule which "could penalise people with BMIs higher than making them pay higher premiums."

I've reported that my nutritionist has clipped a monitor to my finger and reported that my heart is significantly younger than the rest of me.

Melissa McEwen of Shakesville summarizes it this way:
I've noted that these sorts of policies are, truly, nothing more than fat hatred that penalize fat people for the way we look—and this study confirms it. Despite the alleged concern about "health," it's really just a tax we're required to pay, irrespective of our actual health, because we don't conform to a kyriarchetypical Beauty Standard.

BMI is garbage. And using it as a metric to assess health is actively incompatible with meaningful healthcare.

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