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21.03.2022

Use Immunity (Instead of BMI) To Determine A Healthy Weight.

Different people can carry different amounts of weight and still be quite healthy. If we can think about healthy weight in this way, rather than fixating on arbitrary number, good things will happen. I think we’ll see less guilt and shame in our society, and more equitable treatment of people despite their socioeconomic status and it all starts with BMI.

BMI is an acronym for body mass index. It’s a pervasive measure of “health” you’ve likely encountered at the doctor’s office that takes your height and weight into account to produce a value, like 26.5. BMI is quite simply the wrong way to approach this. It is a one-size-fits-all approach to medicine in a world that now offers more nuanced solutions. On top of all that, it can be UNJUST and DISCRIMINATORY.

The connection between weight and structural racism in modern healthcare Weight is such a loaded topic across society, and our healthcare system is no exception. Get a certain BMI number at your next checkup, then all sorts of new conversations and healthcare costs—from more tests to prescription drugs—can ensue. However, there is a growing body of scientific literature—and cultural understanding—that BMI is not just an inadequate measure of health, it’s also a big part of the structural racism that adversely impacts certain communities more than others. The BMI standard was developed for an idealized Caucasian male, and the thresholds remain rather oblivious to important discrepancies warranted by gender and ethnicity. For example, there is evidence that Asian individuals hold onto visceral fat around the belly more, and can thus experience poor health outcomes from excess weight at lower BMIs.

Not to mention the non-racial flaws. Does a pound of lean muscle impact health the same as a pound of visceral fat? Of course not, but an athlete with greater bone density and muscle mass/density can easily register a high BMI. Same goes for pregnant and nursing women.

You are not a number, and a healthy weight depends on so much more than your scale. It’s hurtful to reduce personal health to a number that takes no account of your behaviors and the socioeconomic pressures that play major roles in so many people’s lives. I’m talking about chronic stress and economic inequality.

A better way to think about weight So how should we think about weight? Research has shown that the health problems that come from being overweight do not arise because we simply accumulate more fat cells. It’s the health of those fat cells specifically, the immune health that really matters. We know that people can be overweight but metobically healthy, or have a “normal” weight but poor metabolic health. Why? Because the immune system plays a big role in whether our fat cells are healthy and happy, or angry and damaging to the rest of our bodies. When immune cells get activated to an inflammatory state, our fat cells start to create molecules that further promote inflammation. Think of your immune system as the switch that can turn healthy weight into unhealthy weight.

3 ways to use your immune system to promote a healthy weight

I love a good health metric, and BMI is so prevalent because it’s simple and inexpensive. Unfortunately, it is not all that useful, and our reliance on it perpetuates major social and racial injustices latent in our healthcare system. Rather than BMI, I would like to suggest three alternative ideas to help you connect the dots between your weight and your health. These are ways to harness your body’s complementary systems to make friends with your weight, and stop obsessing about any single number.

1. Improve your immune balance. Research shows that when fat cells start getting inflamed, we start experiencing poor health. This means maintaining immune balance and keeping inflammation in check is key to maintaining a healthy weight. The Mediterranean Diet is a big winner here, so eat more foods rich in plant nutrients and healthy fats.

2. Improve your gut microbiome Health. The gut is a major gateway to the health of our entire bodies. This is especially true as it relates to our fat cells. Everything from your gut microbiome to the integrity of your gut wall may influence your fat cells, so paying attention to gut wellness is key. A good balance of prebiotics and probiotics can really help here.

3. Improve hormonal balance. Hormones like insulin, ghrelin, and leptin are big players when it comes to fat cells, as are a number of lesser-known hormones like GLP-1 and GIP. Maintaining the right balance of these signals may strongly determine whether our fat cells are healthy or unhealthy, as well as our overall weight. Bitter foods like Himalayan tartary buckwheat are a great way to improve this signaling.

The takeaway It is so important that the story around weight gets past BMI. We need to start thinking about the ways in which fat cells become polarized towards an unhealthy state by unexpected players like your immune system, your microbiome, and endocrine signals. It’s a more complex conversation than BMI, but it is the only way to think about weight inside the larger story the one that really matters of overall health and social justice.