But remember that BMI is a number used to diagnose obesity alone, and to identify potential risk factors for health conditions. And that “it is a population-based tool. It was not designed to be used for individuals,” says Sylvia Gonsahn-Bollie, MD, a Black obesity medicine doctor in the Washington, DC, metro area and the author of Embrace You: Your Guide to Transforming Weight-Loss Misconceptions into Lifelong Wellness. “It is very challenging at the individual level for a clinician to really say this is your healthy weight, because we’re using all that bias from the population-based BMI and trying to apply it to the individual.”
Helenica Yusuf, a Brooklyn, New York–based certified dietitian-nutritionist, says the BMIs of the patients in Brookdale Hospital’s diabetes prevention program are recorded because they must reach a certain threshold to qualify. But she usually discusses the measurement with patients — many of whom are Black — only if they ask about it. Otherwise, the focus is on exercising more, eating a healthier diet, and reducing their average blood sugar levels to help prevent type 2 diabetes. “In the process they lose weight, their BMI drops — not significantly — but it drops enough to say that instead of having obesity, now they’re overweight. That’s all right. They’re healthy. Because you can have someone who looks solid but still is very healthy.” Gonsahn-Bollie has some advice for Black people, particularly women, who worry that their healthcare provider is making inaccurate or unfair assessments of them or their health habits based on their BMIs. “First, make sure that your clinician is aware of these adjusted BMI charts. Yes, some doctors will argue that they’re still investigational, but I think it speaks to the fact that we need to at least look at them. Second, have them check your waist circumference. Last, remember that you’re not making excuses when you investigate. You’re empowering yourself.”
