Challenging the BMI: Exploring the New Body Roundness Index

Music.

And welcome to Change Your Relationship with Food, the podcast hosted by me, Kyla Holley. With many years experience as an eating disorder and bariatric therapist, I know exactly what it takes to help you break free from your diet history and develop a more healthy relationship with food. Please follow this podcast to make sure you don't miss a thing. Today, I wanted to introduce something that might be new to you. It's called the Body Roundness Index. Doesn't that sound delicious?

And it's a competitor to what we all know and love, which is the Body Mass Index, the BMI scale. So before we introduce it, let's have a little recap of the one that we know and love, which is the Body Mass Index, the BMI. Just so you know what that is and its limitations before we go into the new contender. And then you can judge what you think, what you like, which one is preferable. So let's go back to BMI.

This was something which was developed actually in 1832, a long time ago, by a gentleman who was called Adolphe Cutelet. That's my attempt at the pronunciation and I apologize to anybody listening in Belgium because I've probably got that wrong. But anyway, he was a mathematician and he set about establishing a quantifiable way of defining the characteristics of, in inverted commas, the normal man.

And he was not a doctor. He was purely a mathematician, statistician, and he was looking for ways to just work out some sort of mathematical equation, I suppose, of the Vitruvian man. If you've seen that famous drawing by Leonardo da Vinci, which actually depicts those sort of ideal body proportions, the measurements and the comparisons of different parts of our body to each other. And the BMI scale is basically weight divided by height squared.

And this became known back then as the Coutelay, again, I'm sorry for my pronunciation, the Coutelay index. And it was, yes, weight divided by height squared. The problem was that all the research that he had done back in 1832 was all on Western European men. That's what the whole thing was based on.

So this sat around for many, many years until the 1950s. And the next real adventure into sort of assessing people's weight and what it all meant was by the Metropolitan Life Insurance Company in the US. And they actually realized that a lot of their claims were coming from individuals at a higher weight. So they, for insurance purposes, started to classify all their incoming clients into certain groups. What they established was what they called the tables of normal weight.

They categorized people basically into small, medium and large. And I suppose that was the sort of early stages of this being important as a means to sort of measure an individual, but also to connect in some way somebody's weight to their health. Then we fast forward to 1972 when good old Ansel Keys appeared, and he was the first person to actually coin that modern term body mass index. And he emphasised with this the convenience of using it in population studies just to analyse data.

So again, even Ansel Keys, who was famous for a lot of good stuff, but also famous for a lot of stuff that got us into trouble later on. That's another podcast. But anyway, Ancel Keys, again, didn't really, I think, intend it to be connected to an individual or as a way of assessing someone's health according to their weight. Then we have to fast forward again to 1997, when the World Health Organization formally formerly recognised obesity as a global epidemic.

And now BMI is very, very widely used. It exists on most people's medical records, and it's actually used as a factor for assessing various diseases among the medical community. And it's kind of, it's probably used a lot because it's easy. It's easy to work it out, but it really doesn't tell the whole story. And we know there's a lot of problems associated with BMI. The first one is, I suppose, that it just looks at your weight.

It doesn't take into account how much of that body weight is muscle and how much is fat. So someone who's very, very muscular, someone who's, for instance, a bodybuilder or some of the rugby players where they're very, very large, very muscular, very solidly built would actually classify as being obese in the BMI scale.

That's very very different comparing someone who is a sportsman for instance a rugby player or a sportswoman can still be a rugby player comparing someone with that sort of physique to someone of the same weight that does absolutely no physical exercise how can you compare one with the other it's very very different they also didn't really compare gender so remember the The whole BMI scale, right from its infancy all the way through, was designed for men, wasn't designed for women at all.

And women have quite a different fat to muscle ratio than men do. Ethnicity is another thing that's completely ignored in the BMI scale. So if you think about different nationalities around the world, so consider the difference, for instance, of somebody from Polynesia and compare them to someone from Japan. They just look very different. They're very different shapes and sizes, and that's not taken into account with the BMI scale.

And neither is age. So again, as we age, our weight tends to go up and certainly our fat distribution changes. And the BMI scale doesn't take any of this into to account. Also, it's not really connected to health. This is a long, long debate that's been going on about health and weight. And I really, truly feel that we shouldn't just connect the two as if it's a given.

So, for example, you might have somebody who is a reasonably high BMI, certainly in the overweight category or even in the obese category, but they are exercising every Every day they eat a really diverse variety of food, which gives them all the nutrition that they need. They're not smoking. They're not drinking alcohol. If they were to have a set of bloods done, everything would come up as normal. Would you say then that person is unhealthy?

Especially maybe if you make the comparison between them and perhaps someone at normal weight, or they actually call it healthy weight on the BMI scale. And that annoys me no end because, again, it supports that assumption that there is a healthy weight. But you might get someone who would appear at that healthy weight, but they're doing the opposite.

They're not taking any exercise. they're eating takeout at every meal they are nutritionally lacking or even malnourished in some areas they're not eating well they're not exercising perhaps they're smoking and drinking a lot but hey their weight is normal and again that gives the impression that they are somehow healthy where everything about their behavior would indicate that there are potential problems there, certainly problems that will come up in the future.

So again, with the BMI scale, it's not perfect. There's all these different reasons why it's not the whole story. And we really, really need to take it with a big old pinch of salt or a big old block of salt in this case.

So let me introduce you to the new kid on the block, which is called the body roundness index. Now, how is this different? Well, what it says is basically it just looks at height and waist measurement and the difference between the two. And I was quite interested in this as a measure. I don't particularly like the name of it, but I'm interested in a measure. And I'll come on to at the end how I sort of scored in both domains and why

this may or may not matter. So what the body roundness index does, it concentrates a little bit more at people's shape. And what it desires, I suppose, is that your waist circumference is a certain percentage of your height or a certain proportion relevant to your height. And I did my measurements on both of these. So a BMI, I came out at 27.6, my BMI came out at, which puts me in the overweight category, which I kind of expected. I sort of knew that that would happen.

And then I did myself in the body roundness index. Now, for those of you that don't know me or haven't actually seen me, I've got quite an hourglass shape. So I'm quite big in the boob department and I'm quite big in the hip department compared to my waist. My waist is a little bit smaller, so I'm sort of hourglass shaped. So I sort of wondered how that would translate into this body roundness index because I'm round in some areas, but the waist isn't one of them.

So I actually came out, my body roundness index was 2.6, which probably means nothing to you. And it actually meant nothing to me, but apparently it does put me in their healthy zone. So there was a little part of me, I'm not going to lie, that sort of did this little internalized, yay, when I found out I was actually in the healthy zone. But then I took a step back and I thought, well, hold on. How does this actually tie together? How does it matter?

And why did I have that little celebratory kind of smile when I found out I actually appeared in the healthy zone of this body roundness index, where as opposed to the BMI index, I'm actually in the unhealthy zone? So it's kind of like, well, I'll take that one and I'll leave the other one behind. But it's not about that, is it? It's not about taking the index that suits you. It's about, does this work? Is this an appropriate measure? Is it something that we actually need in our lives?

And it got me to wondering about shape, because think of the people you know, and I certainly think of the people that I know when I look at these sort of measures, and I wonder how they will fare in these measurements.

So think of a friend and you must have one and perhaps it's you someone that's quite tall they're very lean very sort of straight and they have always been that way so maybe they're very slim on the hips whether they're male or female so their hips and their waist really aren't that different and they've always been this way they're the sort of person that just has never had to worry about their weight. They're tall, they're lean, low body fat.

And it made me wonder how they are going to fare on the body roundness index. So they probably do okay because really the body roundness index is trying to attempt at measuring visceral fat. So the fat that we carry around our middle and particularly visceral fat is the fat we carry inside around our organs. so those people the long straight lean people. They'll probably score pretty well on the body roundness index.

And they would probably, to be fair, score pretty well on the BMI, the body mass index as well. Now think of another friend that you've probably got. Somebody who's got probably quite thin legs, quite thin arms, but they're very round around the middle. So picture that friend. And again, maybe this is you, maybe it's not a friend at all. And tell me, can that person become the long and lean person if they wanted to? Could they actually completely change that body shape that they have?

So just think of this in your mind's eye. You know, I have quite a few friends that are that shape. They're quite slim on the legs and the arms, but they're quite round in the middle. Can that person change that? Can they become that sort of long-shaped person whose waist and hips are very, very similar? Can they do that? And likewise, can your long, straight and lean friend become like me?

Can they become an hourglass? And. Probably can if they have surgery, but can they actually do that naturally? Can that long, straight, lean person develop naturally bigger hips and bigger boobs? Can they do that? I would argue that they can't. And if I'm wrong, please correct me. Please write in. Please tell me how that can be done. And it makes me wonder with the body roundness index, if people are scoring badly on that.

Let's say this is adopted by every doctor from this day forward and you score badly on it. Say you are that person with the thin legs and arms and the round body and your doctor says to you, oh, you've scored really badly on the body roundness index. And I would like you to do something about that because it indicates that your mortality rate is increased. So the chances as if you're dying for some reason, is increased due to this body roundness test.

So tell me what you do. Tell me what you do to change your shape. The body roundness test has said you are too round, but you are a round person. That's your body shape. So let's say you take yourself off and you go on a diet, or even you take the weight loss medications that are available now, a Zempik Wagovi, one of those. Let's say you do that and you actually lose quite a lot of weight. Does that actually fundamentally change your body shape?

Or are you actually still the same shape, but just a lower weight? These are the questions I've got around this body roundness index.

I don't think it's a particularly good successor to the BMI index, and it's all that's on the table at the moment. I would also ask... Do we need either of these? Do we need to be told our score? Do we need to have a number attached to our bodies? Whether it's weight, whether it's BMI, whether it's body roundness. Do we have to attach that number to our bodies? And if we do, what does it say about us? Does it say we're doing well? Does it say we're doing badly? Does stigma come with it?

As part and parcel of attaching that number to our bodies? And is that stigma that comes with these numbers actually more damaging than the number itself? There's lots of things to consider here. So if a doctor puts a number on you and says you have to do something about lowering that number, what do you do? Where do you go from there?

Yes, you can change your weight, but changing your weight doesn't necessarily change your health because it may not change your body fat to body muscle ratio at all. And it may not make health improvements for you if you're still doing all those behaviors which will be detrimental to your health. And likewise, the body roundness index, changing that number isn't necessarily going to change your body roundness. If you're not built that way, you're not built that way. We're not all long and lean.

We come in all different shapes and sizes and all different packages. And are these actually related back to our health? So tell me what you think. I don't know. My internal jury is out on this one. I only heard this phrase last week, the body roundness index. It came up on a training course I did. Somebody mentioned it and I'd never actually heard of it. So I thought I ought to do some investigating and find out what it is just to see whether it's something which is more viable than the BMI. I?

Is it actually more relevant? Is it more viable?

But that just got me into thinking about all these people I know, all the different wonderful shapes and sizes of the people I know, and how they would actually be affected by this new measure. And also our capacity to change. We know that losing weight is hard. We know that when people embark on weight loss, they tend to regain all that weight and some, especially if they do it via dieting.

So we know that being told that you're too high on the BMI scale sends us down a path of, well, what should I do about it? And inevitably that results in a diet, which we know is rubbish. Also with the body roundness index, you know, we have maybe the opportunity to go off and lose But does it actually affect our roundness? And if it doesn't, how do we do that? How on earth do we change our body shape? What we're born with? You know, some might argue this is genetically who we are.

And how do we change that? And is the body roundness index actually setting people up to feel like they've failed more than the BMI scale, the body mass index? Because at least that's based on weight, which is something we can temporarily have a go at changing. But how the hell do we change our shape? I don't know. So as I say, the jury's out on this one. You decide. I will leave it up to you. I just wanted to position that in your mind today so you could have a think about it.

We will chat again next week. Thanks for your time. Goodbye. Thank you so much for your company today. I would also love it if you could follow this podcast. It really does mean a lot to me. Also, we have a six-week online Change Your Relationship with Food course that you can take. Just visit www.acfeb.com and click on the ACFEB and me courses link. There's also a journal and a workbook available on Amazon, and you'll find that link in our bio.

I really hope you can join me again next week. Goodbye. Music.