BMI Is Bunk, but Fat Women Are Diseased: The Hypocrisy of “The Normal (White) Man”

Abstract

“Obesity”, is defined as a body mass index (BMI) ≥ 30. Yet the tool, BMI, has been shown to be flawed in its weight classing. BMI categories were made by relying nearly exclusively on data about middle-class white males, creating “the normal (white) man”. Yet, BMI continues to be used as a diagnostic tool, and is increasingly deployed to stigmatize fat persons as “diseased”. This has critical implications for women—especially Black women and Latinas—who have some of the highest BMIs in the country. But, despite the consternation over the size of the bodies women of color have, there are nearly no studies to date examining the relationship between BMI and rates of chronic illness by race and gender. In this study, we examined the associations between BMI and type 2 diabetes (T2D) for women across race in comparison to white men. Relying on 20 years of NHANES data, we found that while Latinas and Black women were nearly 3 times and over 5 times as likely to have T2D than white men, respectively, the association between BMI and T2D was significantly weaker for Latinas than for white men. The association between BMI and T2D was markedly weaker for Black women. This study shows that racial and gendered health disparities cannot be explained by differences in rates of “obesity” as defined by a white male norm.