I hate the Body Mass Index. Why? Because according to the Body Mass Index (BMI), I am overweight. According to the Body Mass Index, I will likely always be overweight except when I starve myself, at which point I might end up in “healthy”.
The BMI was invented between 1830 and 1850 as a way to determine statistical averages of weight. It does not calculate body types, or fat percentages, or even gender, simply height and weight – and the new “adjusted” BMI’s say that the taller a woman is, the less she should weigh (per inch). But the problem is that the BMI is being used more and more as a diagnostic standard. But even there doctor’s disagree, with some saying 18.5 BMI is a healthy weight, while others say women shouldn’t fall below 20. Meanwhile, the NHS in the UK has set a standard of 13.5 on the BMI scale in order to be treated for anorexia. To put that in perspective, I weight 210 lbs after nine months of exercising a minimum of 8 hours a week and restricting my food intake. To qualify for treatment for anorexia in the UK, I would need to be, according to my height, about 108 lbs. I find that funny because I used to keep this picture of me from high school; all you can see are sticks connecting giant elbow and knee joints, and every rib protruding – I was 170 lbs. Later in college, after eating less than 500 calories a day for 9 months, I was somewhere between 159-162 pounds; I couldn’t generate enough body heat to keep warm, I bruised if I sat or lay down, I would pass out or fall over when I was running (exercise, exercise!) and people said that it “nauseated” them to look at me. I had a hard time with jeans because you could see my entire pelvic bones, the whole bowl shape with skin stretched across them. To see my bones, where you could see my ribs bones breathing in and out even through my clothes, used to give me such satisfaction. But I was never anorexic, right, right, because the BMI tells me, and the doctors, so.
It seems odd because, anorexia seems out of fashion these days. All I seem to read about it bulimia, unless you are a fashion model, that is, like Ana Reston who died of anorexia earlier this year (at death her BMI was 13.5, which would allow her corpse to get treatment in the UK – just too late for her). Since then, Brazil and other countries have started imposing restrictions on models, based again on the BMI indicators. The problem is that the BMI, like any indicator, has serious flaws – particularly when talking about individual people instead of statistics. If you look at Ana Reston’s picture, taken during a long period of anorexia, she doesn’t look anorexic, does she? The other problem is that if you are an athlete, even a fairly serious amateur athlete, you will never score low enough on the BMI to reveal serious eating difficulties (and if you are a serious female athlete, you probably HAVE an eating difficulty).
For example, Shaquille O’Neal has a BMI of 32, which rates him as “obese” to “morbidly obese” and so seriously overweight he is in life threatening danger due to his inactive lifestyle...according to the BMI. But the BMI can't tell how much of your weight is fat or how much is muscle. For instance, amenorrhea, which is when the body fat in women reduces low enough to stop menstrual cycles, is undetectable through BMI and studies have shown that female athletes with amenorrhea and without amenorrhea based on unhealthy versus healthy amounts of body fat score exactly the same on the BMI. And with the weight of muscle over fat, eating disorders are harder to spot among female athletes. That is not to say they don’t exist; eating disorders among serious female athletes are 10 times more prevalent than the average population – though again, because diagnostic indicators are almost irrelevant when used against elite althetes, a Canadian study shows how varied the studies when it states:“The prevalence of eating disorders amongst female athletes is reported to be between 15% and 62%” While two US studies says that at least a third of female athletes have disordered eating. What is constant is that at least ½ of female athletes feel constant pressure regarding weight, and over half are on some form of food regulation. A majority of female athletes want a body fat percentage that is dangerously low (13% compared to the healthy norm of 17-27%), 81% feel “out of control” if they overeat and on every single item on the Rosenberg Self-Esteem Scales female athletes had lower scores than male athletes. Some of this pressure comes from the person: “perfectionism, compulsiveness and high achievement expectations are personality traits thought to be advantageous for the competitive athlete; however these very traits are commonly associated with the development of an eating disorder.” While other times it comes from coaches, the team and the environment, particularly in sports where lean is linked to winning performances.
But what about fencing? Fencing is the “odd” sport, as it doesn’t require a body type; According to Mark Masters, a coach in Philadelphia, "A lot of women who come to fencing haven't participated in conventional sports. In school, they were poor athletes--they couldn't throw a ball, weren't fast runners, couldn't jump high. With fencing, they now have a niche." What they don't tell you about fencing is that, unlike other sports, you will get fit, but not lean. In a study of male teens, fencing created the second highest BMI rating next to weight lifting (a higher BMI than basketball and even swimming). The development of powerful muscles in fencers gives them a BMI rating comparable to the “control” group – the group that sat on the couch playing games and eating cheetos. A look at the 16 top elite fencers at the last Olympics as well as some of the elite Canadian female fencers gives an average BMI of around 24; according to the BMI, just this side of “overweight”.
And how does that affect me? In the six weeks going up to the Nationals, I really poured on the training....and gained 8 pounds. That drove me crazy, particularly as I had restricted my eating significantly. Another female fencer in her thirties said that is just that way it is, welcome to “fencer thighs” and that she, at least 8 or 9 inches shorter than me, was 175 lbs. I should clarify, when I said, “drove me crazy” I mean it started a trigger. The more stress I am under, the less I eat, the more I crave control, the more I exercise. Right now, at most, I eat once a day. My calorie intake for the last month is 1/3 of what it was a couple months ago. It would be even less except years on diet drinks has made me severely allergic to aspartame – so no more meals of diet coke and celery. This is a problem.
I have always said, in private, that anorexia is an addiction, at least for someone like me. It is how I cope in times of trouble and though I have been almost 3 years with “healthy eating” all it takes is enough stress, or enough negative feedback or enough whatever is needed to start the trigger. And I will tip into that need to hold some part of myself in control so that no matter what is done or said to me; I have a part that no one can touch: they can’t make me eat. Of course, I win this “victory” at the cost of my own body. I said it in private because talking about eating disorders is very taboo if you are supposed to be an intelligent professional – you are supposed to have it “together.” So saying that starving is responding to emotional demands which are far greater than the puny emotional influence an idea like “you are threatening your survival” can bring to bear is a bad thing. But actually thanks to Faith over at the blog That is So Queer, I saw that you can post about being both an intelligent human being and a flawed human being.
That being said, it is possible to be both an intelligent human being and have ideas or actions which are not.....let’s call it optimal (I've lost 9 pounds this week, woo hoo!). Starving yourself doesn’t make you perform better, nor does it make you feel happy. It might make you an unhappy person who feels in control. But it also threatens your very future, particularly if you enter what is called the female athlete triad: This triad is characterized by disordered eating, menstrual dysfunction and osteoporosis – and ironically turns an activity which should benefit women into one which shortens their lifespan ("I have seen girls who had been in their 20s who had been amenorrheic for several years who had the bones of a 70- or 80-year-old woman," says Seattle-based research physiologist Barbara Drinkwater). How high the percentage of women in the triad changes from sport to sport but studies indicate that a majority of female athletes are under increasing pressure regarding body image, weight and ideals and a majority develop patterns to deal with it (according to a study by RL Rosen, 75 percent of female college gymnasts who were told by their coaches that they were overweight used pathogenic behaviors to control their weight.)
As Mr. Ho says, I’m a big female, very big. And I don’t think the BMI will ever tell me that I am in the middle of the “healthy” range – no matter how many hours I exercise. I used to have this deal with my body; eat what you want as long as you exercise – it was the pact I made so I would not weigh myself. Yet now, in the best physical condition for a decade, I currently feel guilty for every day I don’t exercise at least an hour and every meal or snack I eat? I’m so healthy that I’m sick. Isn’t it ironic? (Of course, remember, the BMI still labels me as “overweight” so it’s all justified, right? Right?)
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