You Should Know

There's also a lot of people who had essential muscles replaced with fat, thus evading the overweight designation while having an imminent risk of diabetes. This reflects that.

...people...have...waists...that're...half their height‽‽‽‽

What if your torso is large because your large liver because alcoholism?

That's because BMI is actually pretty good as a screening tool. It's easy, simple, and pretty damn accurate when combined with an eyeball test. To the extent that it misclassifies people it is far more likely to underclassify obesity than overclassify. The people complaining just don't want to hear it.

That's an extreme case, but the point still stands. For example, right now, I'm pretty fat, because I haven't shifted the weight I gained over COVID. Even though I'm visibly way larger than I was, I'm not much heavier than I was pre-covid, because I've lost a heckton of muscle. It's insane to me that BMI will look at me pre-covid, and look at me now, and say "that's the same picture". Especially because I personally found that the best and safest way for me to lose weight was to focus on getting strong and fit first.

We ran into it a bunch in the Army. As well as the fat over abs phenomenon. Very few of our BMI failures were actually fat. The Army test was really problematic because they measure your waist and neck. So you're simultaneously trying to lose belly fat, build neck muscle, and maintain energy levels for infantry training. Which is just a bit of a nightmare to be in. Meanwhile every week you're running 30-35 miles, putting 15 hours in the gym, and doing 10 hours of field exercise, all on top of any infantry training.

I think it's one of those things you either run into a lot or very little.

I bike and rock climb, I walk long walks and overall in a good shape, not great, not terrible. When the doctors see my bmi without other metrics, they immediately tell me to lose weight and don't take anything else seriously. I missed very serious illness because of that, every symptom I had was thrown into a pile of "your bmi is bad, lose weight", until one doctor was smart enough to check on me for real.
BMI is incredibly oversimplified and gives lazy or overworked doctors easy way out of doing their jobs, which kills people.

Look at it this way, BMI is a cross section of weight and height. I was considered "overweight" for ages because I just had tree trunk thighs from hiking and weightlifting. Like, less than 16% body fat but told I'm 'overweight' every time I got weighed.

The ruler was fucking wrong.

Nowadays, I'm much more of a fat fuck so the ruler is right now but only just so... I'm still under 25% when using hydrostatic!

i think you’re taking that quote out of context a bit. a few sentences later, the article says

Even physicians have weighed in on the shortcomings of B.M.I. The American Medical Association warned last year that B.M.I. is an imperfect metric that doesn’t account for racial, ethnic, age, sex and gender diversity. It can’t differentiate between individuals who carry a lot of muscle and those with fat in all the wrong places.

“Based on B.M.I., Arnold Schwarzenegger when he was a bodybuilder would have been categorized as obese and needing to lose weight,” said Dr. Wajahat Mehal, director of the Metabolic Health and Weight Loss Program at Yale University.

so the point they seem to be making is that, while BMI is controversial partly because people like to shoot the messenger, it’s also just not a reliable measurement in a medical context, even as a heuristic. the article also goes into more detail on its other shortcomings as well. the article also indicates how BMI was never intended to be used in a medical context. so, there are plenty of valid reasons for wanting a new metric.

but i do think the sentence you quoted isn’t really doing the author any favors in terms of trying to communicate the central point of the article.

Or just make a better ruler?

yeah, been weightlifting for years, and the only time the BMI chart says I'm "healthy" is when I'm at my absolute shreddiest. Looking like I'm starving myself to shoot a nude scene in a movie. And I hate that. I know that when I'm at that weight, I may look great, but I'm also at my weakest. So I hate that this chart subconsciously bullies me into trying to maintain some ridiculous 9-12% body fat range, when that's more of a body building competition range.

If you're frictionless too, physicists will love you

It's not doctors that need to know. It's the insurance companies. They wrote the policies that pay doctors based on the BMI metric. Until those policy changes happen nothing will change.

Insurance companies quietly control so much and most people don't realize it.

BMI has been antiquated for like 15+ years, so my guess is it'll change when they die