Thursday 22 April 2021

BMI: Pie in the Sky?

The Body Mass Index (BMI), was devised in the 1800's, by Lambert Adolphe Quetelet (another famous Belgian!). It's a simple calculation, where the body weight (in kilograms) is divided by the square of the height (in metres). The resulting figure is used to estimate whether an individual has a 'healthy' body weight. BMI, however, takes no account of body shape (ectomorphs and endomorphs), age, ethnic background etc. It is, at best, a rough indicator. Agnes Ayton (Royal College of Psychiatrists) notes that BMI is now the main indicator, used to access scarce specialist care in the UK's NHS, for people with eating disorders ( https://www.theguardian.com/commentisfree/2021/apr/21/bmi-eating-disorder-pandemic-treatment). Ayton feels this is wholly inappropriate. BMI might indicate that someone has anorexia (with an extreme aversion to eating) but it is unlikely to pick up a patient with bulimia (where the individual eats but induces vomiting). The situation appears all the more urgent as some patients with eating disorders are now being tube-fed by their families at home, because of a shortage of hospital beds (https://www.theguardian.com/society/2021/apr/22/eating-disorders-families-tube-feeding-patients-at-home-amid-nhs-bed-shortage). Tube-feeding is a difficult procedure and can produce damage to the patient. Any eating disorder can be life-threatening. Eating disorders have increased in incidence over Covid-19 pandemic lockdowns. The disruptions to medical services has often resulted in physicians not seeing their patients. Relying on BMI measurements to ration hospital treatment could, in some cases, have fatal consequences.

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