BMI = Bloody Meaningless Information

When the people and tools that could make a difference, actually have the opposite effect!

Last Friday was a public holiday here in Melbourne, and as I’d just returned to Melbourne after a fabulous holiday in Thailand and Cambodia with my family, I was keen to nip into my GP for a prescription. Alas the clinic was closed, so on Saturday I booked the carefully selected time of 2pm for an appointment as I knew I could duck in and out for the simple request….

About 4 years ago I developed insomnia.  To give you some back-story to my plight, back in May 2011 I decided to quit smoking.  I successfully did this by retreating to a lovely cottage for a week until the “grumps” were over and I could assimilate back into normal society 😉 A couple of days after quitting, I noticed that I was feeling different – but not in the positive way I had been expecting. Flash forward to mid June and my beautiful dad passed away suddenly. The shock of this event, and the enduring months that followed no doubt added to my health issues. Until then, apart from smoking, and obviously being overweight, my health had been pretty normal.  Now obviously with such a tragic event in my life, it would be normal to think that I would suffer from some emotional and potentially physical reactions. That’s what I kept telling myself when my body was so exhausted it could barely get out of bed in the morning, when I couldn’t sleep at night and when panic attacks and irritable bowel like symptoms began to present. This went on for a few weeks until it was impossible to ignore the warning signs. Something was seriously wrong. As we all do as women, we focus on our families, our work and just getting on with it, but this was becoming impossible.

I started googling (yep I know, not recommended, but still, I needed some answers). I presented to my then GP who offered Stillnox as a solution. WTF? No way, so I decided to try for a 2nd opinion. The next one I visited suggested that “If you only lose some weight you won’t feel so tired”. I was gobsmacked, and needless to say I left the office without a stillnox prescription and with no answers.

In the interests of keeping the story succinct, I finally, after visits to more than 5 mainstream doctors, I gave my friend Andrea Hepner a call. Andrea is a naturopath and runs a clinic called Empowered Health. I was unable to attend her office as I could barely move at this point, so she kindly offered me a Skype consultation and she went through a thorough line of questioning and testing that NEVER involved weight.  Andrea started me on the path of diagnosis and help, and I will be forever grateful to her for her incredible attitude and approach to health. It turns out I have a metabolic disorder. It seems this disorder is often dormant (as it’s genetic) until triggered by a stressful life event and it’s now clear to me now that I know what the problem is, that in the preceeding years I had been experiencing minor symptoms that were in hindsight the indicator that something bigger was coming!  I had adrenal fatigue bordering on adrenal failure, chronic insomnia, my iron level was so low that it was a miracle I was still standing and my bowel was so sick from the adrenal fatigue that it took months to improve.  In fact, it turns out that my smoking had actually covered-up the extreme symptoms, that with the stress and then quitting, in one hit came on with vengeance. With the help of Andrea, and thereafter an Intergrative GP who specialises in this condition, I have clawed my way back from this chronic illness into a healthy state.  I’m so grateful to my husband, my family and friends and of course the professionals who helped me during this difficult time, their support was unwavering. It’s incredibly scary to think that had I not been a “strong” person I would have been taking the advice of “professionals” offering incorrect medications and incorrect diagnosis of my condition.

I’m happy to say that this condition is completely manageable and I now take daily supplements to maintain the happy healthy place my body is now at.  Interestingly, my 12 year old son was diagnosed with the same condition just over a year ago, I was so relieved that he presented with the symptoms well and truly AFTER I had gone through the tough process of diagnosing it. When he developed it, I recognised the signs immediately and already had the help in place. He’s doing great!

So, back to that appointment I had last weekend. As I mentioned I see an Integrative GP who specialises in my condition, but for the everyday things, I have a local clinic that our family frequents. When my insomnia is bad, I sometimes have to take a sleeping tablet to “train” my sleep pattern back.  So I’m waiting for my turn, the GP calls my name and off we go into her office. She asks why I’m there today? I state that I’d like a repeat of my sleeping tablet prescription. She hesitates – which I understand, these drugs can be abused and used incorrectly, so knowing this, but knowing that I have a legitimate use for them, I’m happy to jump through the hoops to justify this.  However, the line of questioning then proceeds down the path of, do I feel suicidal? Am I depressed? Am I working on my weight? ummmm hang on, what????????????  She then launched into “diagnosing me” with sleep apnoea.  I don’t have sleep apnoea. My symptoms aren’t even close to sleep apnoea. I know this because I’ve googled the symptoms AND because I’ve already been down the diagnosis route before with a doctor to confirm this!!!!!!! She then decides that she needs to refer me to a sleep clinic for sleep apnoea. I said I was happy to see a sleep specialist if she thought that would help. She then tells me that she needs a few “facts” first. Yep here it comes…

What’s my weight? I tell her. What’s my height? I tell her. Then I hold my breath as I wait for the inevitable, I know what’s coming next. Yep you guessed it – “AAAGGGHHH”, she says after a moment of calculating… “Your BMI is Enormous!” (yep she said “enormous”), “I need to take your blood pressure”.

Are you serious? Take my blood pressure now…. I didn’t need to look at the result to know that it was going to be – high – very high!

She then asks if I’ve ever had an issue with blood pressure? “No”, I say honestly. “Right”, she says – clearly doubting my answer.

My blood pressure was at this point 133 over 90.  She then announces that I have hypertension and if I don’t “lose weight immediately you will be in serious trouble”.

Wow.

So at this point my heart is pounding in my ears, I’m trying to remain calm, ignore the bullshit, and focus on getting that prescription – with the knowledge that my Integrative GP – who I trust implicitly has NEVER worried about my weight during the whole 4 years I’ve been consulting her for the other condition.  The focus has been on wellbeing and health, never about my BMI.

The GP’s voice comes back into my awareness as she’s droning on about weight and what I can do to work on this. I consider losing my cool and having a complete rant at her. But then I realised – obviously – nothing I say to her is going to make any difference at all. It was clear that the moment she laid eyes on me she had decided what her course of action was going to be.

I stated “I do not wish to discuss my weight with you”.

She was shocked.

She was speechless.

She said “well, someone needs to help you”.

Did this woman seriously spend 4-6 years in University to earn a PhD? What are we teaching our doctors? How is it that I knew more than she did? and more importantly – do they teach these medical professionals that empowering your patient is their best chance at success? (no need to answer that – doh!).

She then huffed and puffed, made a big performance about printing out the prescription, handed it to me and said “Is there anything else? to which I replied, “no thank you, have a lovely weekend” and walked out.

255712-bmi-measurementI can’t stop wondering how if I had been a woman with a distorted body  image, would I have coped with this barrage of rubbish? What would I have done?  The damage that this attitude is doing to the population is overwhelming. It’s wrong. It’s actually creating a larger problem.

The fact that a qualified GP is still in this day and age using the BMI (body mass indicator) to calculate a patients’ health is gobsmacking.

For the record my BMI is 40 – based on the online BMI calculator I need to lose between 47-66 kgs to be a “normal” body weight. That is over half my body weight – wow, just wow!.  The current BMI formula (which is literally dividing your height by your weight) leads to confusion and misinformation.  In fact Nick Trefethen, Professor of Numerical Analysis at Oxford University’s Mathematical Institute wrote a letter to The Economist that “the BMI formula is flawed and is only a rough guide to helping people judge whether they have a healthy weight”.  It goes on to say that when the BMI calculator was developed there were no computers, calculators or electronic devices, so they opted for a very simple system.  Trefethen does wonder, though, why institutions on both sides of The Atlantic continue using the same flawed formula?  Good question?! You can read more here…  In fact, the flaws just keep coming, especially if you compare a “Couch Potato” to “an Athlete” with the same height and approx. weight, yet one does an incredible amount of exercise and the other doesn’t – their BMI is practically the same!  RIDICULOUS!

In my case, and based on my personal story above:

There is NO evidence that BMI induces Insomnia. FULL STOP.

There is NO evidence that “Stillnox” is going to cure my Metabolic Disorder, nor insomnia. FULL STOP

There is NO evidence that being rude, condescending and offering INCORRECT advice to a human who is obese, overweight or otherwise is going to help the “Obesity Crisis/Obesity Paranoia” that is so incredibly misunderstood.

I don’t dispute, nor deny or ignore that obesity has an impact on health, that is a fact.

I am obese. That’s a fact.

BUT, I am so much more than that, and so is my health.

On Saturday I posted about my visit on Facebook, within minutes I had ladies commenting on their own experiences with health professionals. Appalling is the word for it, so many stories (and for the record I have about 10 others of my own experiences I could have chosen to tell here).

One lady spoke of her 4 year old daughter deemed “Obese” at a Maternal Child Health Nurse check-up, another had a pain in her hip, her GP did a “poke around” the general area and then announced that if she lost weight it wouldn’t hurt anymore!!!???!!! – her Personal Trainer (!) diagnosed a muscle strain from exercise. Yep. That. And then there was the comment by a highly regarded dietician and Body Positive Ambassador who had a client come in this week after a visit to her GP for a rash, and left with a lecture on her weight and highly inappropriate diet advice – oh lordy, it just goes on and on. Oh and how about the women who commented on being shamed for their weight when presenting for their annual pap smears – wow, just wow.

As a survivor of cervical cancer it makes me shudder to think that a Dr’s attitude to obesity could prevent a woman having a potentially life-saving check-up simply by shaming her about her weight.

THIS APPROACH AND ATTITUDE NEEDS TO CHANGE NOW.

There ARE great GPs and specialists out there. There are organisations and professionals who are working hard to educate the general population of GPs and specialists, and working in our Universitites to change the education and “speak”.  Namely the gorgeous Sarah and Fiona at Body Positive Australia to name just one such organisation.

It’s time to change this. I want to create a list of BODY POSITIVE – Wellbeing focussed GPs and Specialists. I know that some have done this in the past, and I’d love to hear from anyone that would like to collaborate on this project. I will be setting up a page on my website to list these Drs, so that NO ONE has to be subjected to such pathetic and negative health care in the future.

It’s MY body,

It’s MY choice

and it’s MY right to have positive health care with an accurate and educative approach.

Stay tuned for the details of how to submit your recommendations of body positive health professionals, and feel free to share your stories below.

Love your shape!

Janine x

**Thanks to Becca for coining the term “Bloody Meaningless Information” -she kindly allowed me to adopt the term – says it perfectly don’t you think?!

PS – For those that consider the above to be promoting obesity – you are WRONG. This is about healthcare delivered in a body positive and empowering manner – not to mention potentially life-saving. It’s what we ALL deserve.

5 thoughts on “BMI = Bloody Meaningless Information

  1. Janine it is staggering how much emphasis is put on the BMI. I have been researching bariatric surgery only at the insistence of my Orthopeadic surgeon and have been looking at numerous specialists on the Gold Coast and talking to people and have been disgusted how everything comes down to your BMI. It is so unrealistic. I am 5.11 and yes overweight but am told my BMI for age etc should be 27!!!!! I should weigh 65-72 kg’s. Not in a lifetime. It is very sad and frustrating. Totally unrealistic. On a side note I am astounded how common and trendy bariatric surgery is on the GC. It seems to be the easy option for weight loss. I am going to be myself.

  2. Don’t get me started on BMI! So many medical professionals are still stuck on the use of BMI and see it as the be all and end all of health. Well I’m obese according to my BMI. I’m also a personal trainer, and a very successful one at that. However, I don’t look like your stereotypical personal trainer. I’m a size 18 for one thing. The response when I told a doctor my job recently? “You’ve got to be kidding! But you’re fat!”. How rude is that? I’m very secure in my body and in my profession. But what if I wasn’t? I get a lot of ladies who come and train with me because they can relate to me. The ripped young male trainers in my gym intimidate them and they feel the other woman, who is young and extremely fit looking, will judge them. When my scales flash up their BMI their eyes widen, and there are often tears. I tell them not to worry, not just about their BMI, but their scale weight. BMI is a load of rubbish! It doesn’t take into consideration lean muscle mass, hydration levels, body fat percentage etc. Recently I changed my training regime. My body fat percentage went down 3% but my BMI went up – I got heavier due to an increase in muscle mass. My doctor was horrified and tried to refer me to a slimming club!

  3. Janine, more savvy doctors and nurses know that if you put a standard size blood pressure cuff on a plus size patient you are likely to get a falsely high blood pressure reading. I’ve even read about a pregnant woman who was being pressured by multiple hospital staff to have a C section as they automatically assumed her high blood pressure meant she had pre-eclampsia. They ignored her file showing she had normal BP prior and ignored that she had no other signs of eclamsia. Luckily she knew about the difference BP cuff sizes made so she stood her ground despite the coercion until her obgyn arrived. He then used the right size cuff and rebuked the hospital staff for being so stupid. They might have forced her into unnecessary surgery of she hadn’t have known.

    I’ve had an ultrasound tech assume I had high BP and gestational diabetes. They were quite surprised when I told them I had neither.

    I also had hyperemesis gravidarum with both my pregnancies and because I was fat, people thought it was a good thing because “at least I was losing weight, right?”

  4. After having an accident, i was told the pain i had in my leg was just because im so obese and i just have tissue damage… by 3 different doctors. No tests just blame in on the fat. 3 weeks and a good g.p later, i found out id been hobbling arount on a dislocated kneecap and 2 fractures!
    I was home bound and got bigger and more depressed. I went to another g.p (in the same surgery with all my notes) as mine wasnt avail, just to get another anti-depressant script. The doctor procedded to tell me “you dont have any real problems, think of the people in all the 3rd world countries, you have a good life, all you need to do is loose weight” when i got upset she told me there is no reason that i sld be crying.
    Im so so very sick of professionals not being able to see past peoples weight. Oh and the medical board didnt care….imagine if you were suicidal and people kept saying this shit to you!

  5. I have to say I have been fortunate in finding a GP that understands that not every human being is born to be a size 8, and in fact progressively, her attitude is that you can be overweight and be fit and healthy and this is much more beneficial than being skinny but not exercising or eating right. Her attitude is your overall health is more important than the number on the scales and I am very thankful I have such a great GP to deal with as so many people don’t.

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