When it comes to health and nutrition, academia goes through fads, they make their way to government panels, and then popular culture is stuck with them.

So it goes with the Body Mass Index (BMI), now decades into being used by health insurance companies, health experts and government pundits as a proxy for health. But it was never correct. A muscular person with very low body fat can have a high BMO and a ratio of weight to height never made much sense for other reasons as well. Since government now controls health care, a rule proposed in April by the Equal Employment Opportunity Commission will force people with higher BMIs to pay higher health insurance premiums.  The proposed EEOC rule would allow employers to charge higher insurance rates to people whose BMI is 25 or higher. A BMI between 18.5 and 24.99 is considered normal. 

Thanks to BMI, 54 million healthy Americans are "unhealthy" - even though they are not. It is as crazy as CDC Dr. Tom Frieden trying to encourage people to believe they have a ridiculous "pre-diabetes" problem.

"Many people see obesity as a death sentence," said A. Janet Tomiyama, an assistant professor of psychology in the UCLA College, about the BMI problem in  the International Journal of Obesity. "But the data show there are tens of millions of people who are overweight and obese and are perfectly healthy."


  A. Janet Tomiyama. Credit: Courtesy of A. Janet Tomiyama

The psychologists analyzed the link between BMI -- which is calculated by dividing a person's weight in kilograms by the square of the person's height in meters -- and several health markers, including blood pressure and glucose, cholesterol and triglyceride levels, using data from the most recent National Health and Nutrition Examination Survey.

They found that close to half of Americans who are considered "overweight" by virtue of their BMIs (47.4 percent, or 34.4 million people) are healthy, as are 19.8 million who are considered "obese." Given their health readings other than BMI, the people in both of those groups would be unlikely to incur higher medical expenses, and it would be unfair to charge them more for health care premiums, Tomiyama said.

Among the other findings:

  • More than 30 percent of those with BMIs in the "normal" range -- about 20.7 million people -- are actually unhealthy based on their other health data.

  • More than 2 million people who are considered "very obese" by virtue of having a BMI of 35 or higher are actually healthy. That's about 15 percent of Americans who are classified as very obese.

Tomiyama, who directs UCLA's Dieting, Stress and Health laboratory, also called DiSH, found in previous research that there was no clear connection between weight loss and health improvements related to hypertension, diabetes, and cholesterol and blood glucose levels.

She said she was surprised at the magnitude of the numbers in the latest study.

"There are healthy people who could be penalized based on a faulty health measure, while the unhealthy people of normal weight will fly under the radar and won't get charged more for their health insurance," she said. "Employers, policy makers and insurance companies should focus on actual health markers."

Jeffrey Hunger, a co-author of the paper and a doctoral candidate at UC Santa Barbara, said the research shows that BMI is a deeply flawed measure of health. "This should be the final nail in the coffin for BMI," he said.