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BMI Is Bullsh*t – Here’s Why It’s Time for Doctors to Ditch It — Everyday Feminism

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Originally published on Adios Barbie and republished here with their permission.

(Content Note: Disordered eating)

“Here, take these,” he said. “We give them to everyone.”

I stared at the nurse and reached for the papers he was holding. I had been to this clinic several times before, and my appointments had never ended like this.

His tone remained relatively normal, although he seemed uncomfortable. He smiled and leaned toward me to show me what he was holding. The first paper was titled, “Tips for Losing Weight.” It listed my weight and BMI, and noted that my BMI fell within the overweight range. It then listed health issues associated with being overweight and tips for changing my diet and exercise routine. Below this sheet was a packet devoted to similar pointers.

I felt sick. I didn’t know what to do, so I took them. I scanned the top sheet. The “tips” were things like “Park further [sic] away in the parking lot,” and “March in place.” I stopped reading and stood up to go back to the lobby.

Thoughts flickered through my brain. They see you and they think you’re fat. It’s good that I didn’t have breakfast this morning. I shouldn’t eat for the rest of the day. My hands twitched to download the calorie-counting app I promised myself I would never use again. I tried not to cry.

Maybe my reaction would have been different if I had been prepared for this interaction. Maybe not. In any case, I had come to talk about birth control options, not my weight. Talking about my weight made me lightheaded and shaky.

My eating disorder began to develop seven years before this trip to the doctor’s office.

Growing up, I had learned to be unhappy with my body. I flirted on and off with dieting, but, for the most part, it didn’t make sense to me. I was a figure skater, and I needed the energy from food to succeed. My love for the sport overrode everything else in my life, and that included my relationship with food.

And then my life started to fall apart. I dropped out of high school and quit figure skating and suddenly everything felt out of control. So when I discovered a website that would help me keep track of every calorie I consumed, I was hooked.

It didn’t take long for counting calories to become an obsession. I began counting the calories in gum and crying when I ate too many calories of rice. But it wasn’t enough. I started running, and soon I was running miles every day. The number on the scale haunted me, and I always knew what it was, up to the tenth of a pound.

When things got really bad, I would binge eat until my stomach burned and occasionally throw it all back up. My period stopped, and I started to develop severe health issues. I was in trouble and there was no end in sight.

Until there was. With love and support from my community, I started to recover. I stopped counting and started learning how to eat again. I gained the weight back, reached the weight I am now, and then stopped. My period started again, and my health issues disappeared. It was like my body was breathing a sigh of relief.

So this is why this incident at the doctor’s office startled and upset me. Not only was I not there to talk about my weight, but my relationship with food was fragile at best. Handing me these papers threw me into a tailspin.

It could be argued that what this nurse did was based on concern for my health, and that it was medically necessary to point out that my BMI made me overweight. Except, BMI is not a medically relevant scale. In fact, BMI doesn’t even provide an accurate depiction of your overall health. All BMI does is divide weight by height and produce a fairly arbitrary number.

And this number can have consequences. A study published in the International Journal of Obesity reports that “nearly 75 million adults in the US are misclassified as either healthy or unhealthy when BMI is used as the sole health indicator.” Essentially, when more precise cardiometabolic tests are used, they indicate the medical irrelevance of BMI.

So why do doctors still rely on BMI? Many people agree that it’s because BMI is cheap and easy. All a doctor needs to calculate it is their patient’s height and weight. But, while BMI is accurate in this calculation (i.e. dividing that weight by that height and producing a number), the number it produces is arbitrary and an inaccurate representation of that person’s health.

Inaccuracy shouldn’t have a place in any medical discipline.

And my BMI certainly shouldn’t have a place in a conversation about birth control. I understand the medical necessity of monitoring my overall health when prescribing something new or changing the way my reproductive system runs. However, my BMI is not a helpful measure of this by any stretch of the imagination.

And this isn’t true for only me. There have been many, many cases of healthy women falling into categories describing them as overweight or obese and unhealthy, and vice versa. But as my BMI went up during my recovery, my overall health stabilized. I started taking better care of myself and, as a result, I gained weight. My experience is just one example that health and weight are not, as we have been led to believe, inextricably linked. In fact, they are two totally different things.

So I’m going to continue doing what I need to do to feel good and be a healthy human being. It would be nice if I didn’t have to do so while avoiding triggering-and-definitely-unhelpful information at my doctor’s office.

And, regardless of any of this, BMI is still bullshit as a measure of health. Dividing someone’s weight by their height cannot possibly encompass all of who they are and all the factors of their health. BMI strives to boil health down to a simple number, and it fails miserably. So let’s go ahead and retire it already.

Lisbeth is a recent graduate from the University of Southern California, where she received a B.A. in English with an emphasis in creative writing. A lifelong feminist, Lisbeth has devoted much of her time to studying the perception of women and gender roles throughout history and in modern popular culture, and values critiquing the construction of “harmless” media. When she is not working on stories for her fiction blog, Opening Doors at 3 AM, Lisbeth enjoys tearing up the dance floor, drinking bourbon from champagne glasses, and watching videos of bulldog puppies on YouTube.

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14 hours ago
Overland Park, KS
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Matilda star Mara Wilson says she made ’emotional’ decision to come out after Orlando

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Matilda star Mara Wilson has suggested that she may not have come out if it wasn't for the Orlando Pulse massacre in which 49 people died.
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19 hours ago
Overland Park, KS
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Time Traveled


Time Traveled

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1 day ago
Overland Park, KS
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Alphabet CEO ordered Google Fiber to downsize, report claims

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Google Fiber has reportedly fallen "well short" of its goal of signing up 5 million subscribers and may be on the verge of making significant staff cuts.

"Last month, Alphabet CEO Larry Page ordered Google Fiber’s chief, Craig Barratt, to halve the size of the Google Fiber team to 500 people," according to a paywalled report from The Information that quotes people "close to Alphabet."

The report does not say whether any staff cuts have already occurred.

Google Fiber was announced in February 2010, and its first deployment went live in Kansas City in November 2012. The company reportedly hoped to get 5 million customers within five years, but by the end of 2014, Google Fiber had just 200,000 Internet subscribers. While an updated number hasn't been revealed, "it’s still well short of initial expectations," The Information report said. The cost of installing fiber in each city has also exceeded Alphabet's expectations, the report said.

Google Fiber also has hit delays in getting access to incumbent providers' utility poles.

"It's believed that the company's TV subscriber sign-up totals have been even worse, with one analyst last March suggesting that Google Fiber had just 53,390 pay TV subscribers as of the end of last year," DSLReports noted today.

We contacted Google Fiber about the reported subscriber numbers and staff cuts today but have not received any official statement.

Google Fiber did just go live yesterday in Salt Lake City, Utah, its seventh metro area. But the ISP delayed plans to install fiber lines in San Jose last month, and it reportedly also suspended a project in Portland, Oregon. Future construction could instead use wireless technology, which may speed up the pace of deployment. But Google Fiber's wireless technology would be best suited to multi-unit residential buildings and businesses, potentially making it difficult to serve single-family homes.

During a recent earnings call (transcript), Alphabet CFO Ruth Porat said the company still sees Google Fiber as "a huge market opportunity" but that it's "being thoughtful and deliberate in [its] execution path."

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1 day ago
I'm becoming a bit less optimistic about getting Google Fiber service to my apartment. :(
Overland Park, KS
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Can Software Make You Less Racist?

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I don't think we computer geeks appreciate how profoundly the rise of the smartphone, and Facebook, has changed the Internet audience. It's something that really only happened in the last five years, as smartphones and data plans dropped radically in price and became accessible – and addictive – to huge segments of the population.

People may have regularly used computers in 2007, sure, but that is a very different thing than having your computer in your pocket, 24/7, with you every step of every day, integrated into your life. As Jerry Seinfeld noted in 2014:

But I know you got your phone. Everybody here's got their phone. There's not one person here who doesn't have it. You better have it … you gotta have it. Because there is no safety, there is no comfort, there is no security for you in this life any more … unless when you're walking down the street you can feel a hard rectangle in your pants.

It's an addiction that is new to millions – but eerily familiar to us.

The good news is that, at this moment, every human being is far more connected to their fellow humans than any human has ever been in the entirety of recorded history.

Spoiler alert: that's also the bad news.

Nextdoor is a Facebook-alike focused on specific neighborhoods. The idea is that you and everyone else on your block would join, and you can privately discuss local events, block parties, and generally hang out like neighbors do. It's a good idea, and my wife started using it a fair amount in the last few years. We feel more connected to our neighbors through the service. But one unfortunate thing you'll find out when using Nextdoor is that your neighbors are probably a little bit racist.

I don't use Nextdoor myself, but I remember Betsy specifically complaining about the casual racism she saw there, and I've also seen it mentioned several times on Twitter by people I follow. They're not the only ones. It became so epidemic that Nextdoor got a reputation for being a racial profiling hub. Which is obviously not good.

Social networking historically trends young, with the early adopters. Facebook launched as a site for college students. But as those networks grow, they inevitably age. They begin to include older people. And those older people will, statistically speaking, be more racist. I apologize if this sounds ageist, but let me ask you something: do you consider your parents a little racist? I will personally admit that one of my parents is definitely someone I would label a little bit racist. It's … not awesome.

The older the person, the more likely they are to have these "old fashioned" notions that the mere presence of differently-colored people on your block is inherently suspicious, and marriage should probably be defined as between a man and a woman.

In one meta-analysis by Jeffrey Lax and Justin Phillips of Columbia University, a majority of 18–29 year old Americans in 38 states support same sex marriage while in only 6 states do less than 45% of 18–29 year olds support same-sex marriage. At the same time not a single state shows support for same-sex marriage greater than 35% amongst those 64 and older

The idea that regressive social opinions correlate with age isn't an opinion; it's a statistical fact.

Support for same-sex marriage in the U.S.

18 - 29 years old    65%
30 - 49 years old    54%
50 - 64 years old    45%
65+ years old        39%

Are there progressive septuagenarians? Sure there are. But not many.

To me, failure to support same-sex marriage is as inconceivable as failing to support interracial marriage. Which was not that long ago, to the tune of the late 60s and early 70s. If you want some truly hair-raising reading, try Loving v. Virginia on for size. Because Virginia is for lovers. Just not those kind of lovers, 49 years ago. In the interests of full disclosure, I am 45 years old, and I graduated from the University of Virginia.

With Nextdoor, you're more connected with your neighbors than ever before. But through that connection you may also find out some regressive things about your neighbors that you'd never have discovered in years of the traditional daily routine of polite waves, hellos from the driveway, and casual sidewalk conversations.

To their immense credit, rather than accepting this status quo, Nextdoor did what any self-respecting computer geek would do: they changed their software. Now, when you attempt to post about a crime or suspicious activity …

… you get smart, just in time nudges to think less about race, and more about behavior.

The results were striking:

Nextdoor claims this new multi-step system has, so far, reduced instances of racial profiling by 75%. It’s also decreased considerably the number of notes about crime and safety. During testing, the number of crime and safety issue reports abandoned before being published rose by 50%. “It’s a fairly significant dropoff,” said Tolia, “but we believe that, for Nextdoor, quality is more important than quantity.”

I'm a huge fan of designing software to help nudge people, at exactly the right time, to be their better selves. And this is a textbook example of doing it right.

Would using Nextdoor and encountering these dialogs make my aforementioned parent a little bit less racist? Probably not. But I like to think they would stop for at least a moment and consider the importance of focusing on the behavior that is problematic, rather than the individual person. This is a philosophy I promoted on Stack Overflow, I continue to promote with Discourse, and I reinforce daily with our three kids. You never, ever judge someone by what they look like. Look at what they do instead.

If you were getting excited about the prospect of validating Betteridge's Law yet again, I'm sorry to disappoint you. I truly do believe software, properly designed software, can not only help us be more civil to each other, but can also help people – maybe even people you love – behave a bit less like racists online.

[advertisement] At Stack Overflow, we help developers learn, share, and grow. Whether you’re looking for your next dream job or looking to build out your team, we've got your back.
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2 days ago
Overland Park, KS
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4 public comments
2 days ago
This is a very, VERY low bar to clear. Like...THE LOWEST.
Portland, OR
2 days ago
1. Just checked ND, and my neighbors are excellent about racial things, but man, they're unloading some ugly ass furniture.

2. Any chance we can roll out a version of this software to the police? They seem to need extra help in this area.
2 days ago
They have a terrible reputation here for this kind of racist commentary. Maybe this will help…
Washington, DC
2 days ago
Nextdoor is still pretty racist, though. I see stuff like, "black person wearing ____ and _____ parked on my street and walked away," at least once a week. And my neighborhood is fairly diverse.
2 days ago
I shit you not: just now the "community lead" in my Nextdoor neighborhood made a post about making police and firefighters a protected class for hate crimes. Figures this blue lives matter shit gets spewed from the same guy who deleted multiple posts of people saying they were uncomfortable with a pretty racist OPD press release a few months back.

When the Princess Screams - GeekDad

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Image: The WB

Can’t even shout, can’t even cry
The Gentlemen are coming by
Looking in windows, knocking on doors
They need to take seven and they might take yours
Can’t call to mom, can’t say a word
You’re gonna die screaming but you won’t be heard.
“Hush,” Buffy the Vampire Slayer

Everyone has a Gentleman. Gentleman is the guy that everyone thinks is sweet and kind. They seem unassuming. Every girl really likes him as a friend. That friendship is the one that always somehow ends up blossoming into romance.

And all the other girls think, “She’s so lucky. He’s such a nice guy.”

Gentlemen are the ones we assume are the hidden gems. All the girls watch you and Gentleman and tell you how lucky you are. “Look how much he cares about you.”

You do look. Because everyone just told you how amazing he is, you try to be worthy of his love.

You realize that you’re not able to spend as much time together as he’d like because he types slowly. So, you start having him dictate his papers to you because you type faster.

He’s particular about his clothing and spends an inordinate amount of time ironing his clothes. You’re done with your work early, so you start ironing for him so you can watch television together.

He needs to have the television on while you study, even though you like it quiet.

He promises you that while you are both on summer break, he will be sure to drive the forty-five minutes to visit you. Even though you’re working full time while he stays home with no job, he’s too tired to visit you. He’s awake every Tuesday at 6am to visit Toys”R”Us to check out the new shipment of action figures, but that’s so exhausting that he can’t come visit you at all. So, you drive to him. 45 minutes up. 45 minutes back. He goes out to dinner with you for 20 minutes before telling you he’s tired.

So you break up with him. You decide that you’re no one’s serving girl.

And one morning, before everyone comes back from summer break, while you’re in your dorm room alone because you’ve moved in early, you hear a knock. Assuming it’s your roommates, you open the door.

There he is.




And in that moment, you hold your resolve. Your anger bubbles up. You feel it rising like bile about to spew.
His face is wet. Tears are rolling down his cheeks. The apologies flow at the same speed as the tears. He loves you. He needs you. He had no idea.

You are weak. You say yes.

And as your friends and roommates file back into the dorms, they are thrilled because the whole group dynamic is safe.

You type papers. You iron clothes. You engage in physical experiences that you start to question. He never asked. He waited until you suggested it. Somehow, he’s no longer aroused by you in the same way. You have homework but you also have a duty. So you move on to another experience to speed up the process. And another. And another.

And you cry. Silently. The tears roll down your cheeks as you sit in Trinity Church in Boston because you are ashamed and don’t believe God should forgive you.

There’s an accident with a condom. You drive home to your parents’ house since they live nearby. You are clearly drunk. You scare them. You call to tell him you’re safe. He has passed out and doesn’t answer. You find out two days later.

There’s a morning after pill. You lie in his bed under the covers wondering whether the cramps mean that you’ve terminated a fetus that you’ve been raised to believe is killing a child. He goes to class and tells all your friends you have the stomach flu.

And you cry. Silently.

He promises to take you on dates. He misses them. You are stranded waiting for him while he goes out for hours making you wait. His roommate takes you to the movie he was supposed to take you to.

And you cry. Silently.

You win an award he feels he should have won. You go on a trip. Over the phone, he accuses you of cheating. He refuses to believe that you were spending time with a male friend but doing nothing with him.

When you come home, he hands you a painting he made for you because he was thinking of you.

Because you are 19 and your mind is younger, you fall in love all over again.

He makes promises. He breaks promises. It’s your fault that your feelings are hurt.

And you cry. Silently.

After 18 months, you realize that your silent tears have become your bondage. He doesn’t need rope or chains to bind you to him. He has done it through the silence of your tears and your isolation. He has broken you. He has broken your bonds with your friends.

And as you break up, because you have the same friends, you promise that you will both stay silent as to the reasons.

This time, you don’t cry. You are just


He feeds on your silence. He grows stronger by your silence. Your silence further isolates you. You take to avoiding him. Avoiding them. Avoiding daytime life.

You make new acquaintances. You forge a new life without him, without them.

You remain


That silence is his continued power over you. That silence means you cannot listen as people expound upon his wonders and his exploits.

“Because you’re still friends! It was an amicable breakup!”

But they start spending more time with him. You spend more time alone.

In silence.

One night, a mutual acquaintance informs you that he’s worried you’re becoming an alcoholic without him. That he’s told everyone his reasons for the breakup and told everyone how worried he is.

His words.

Your silence.

The thing is that the emotional abuse doesn’t need to be obvious.

He doesn’t need to yell that you are a “b*tch” or a “slut.” He doesn’t need to raise a hand to you.

He needs your silence.

Your silence makes you feel complicit. Your silence publicly equates approval.

“If you didn’t like it, why didn’t you say anything?”

Your silence is your shroud. As the part of you that existed before him dies, you mourn it. Silently.

Our silence is the common denominator. In the face of the emotional abuse, our silence is what allows it to continue.

When you first speak, your voice is tremulous and unsure. It starts as a whisper. The cacophony of disbelief drowns out your words.

“But he’s a great guy! You misunderstood! You’ve never complained before!”

Silencing once more your tentative voice.

So you scream.

When Buffy found the box with her stolen voice, she screamed. Break the box. Break the silence. Break someone else’s box. Break the silence. Buffy’s scream saved herself and others. We all have the power to break the box, to break the silence, for ourselves or for others.

Today, I am a Slayer. This is me breaking my box. As my husband noted, “This is your story to tell. It is who you were then, and made you who you are now.”  I can break the Gentleman’s box for myself and for the community of women like me. I have the power to do that, to show other women that we do not need to let those who stole our voices keep them. With the privilege of a place of broadcast comes a responsibility to others. If I have a place where I can show others that they’re not alone, then I have a responsibility to do that. I will break the box and explode the Gentlemen.

Gentlemen lose their power when the princess screams. My Gentleman had power until today. What about your Gentleman? Or yours?

Karen Walsh

Karen Walsh is a part time, extended contract, first year writing instructor at the University of Hartford. In other words, she's SuperAdjunct, complete with capes and Jedi robe worn during grading. She also works as a contract internal regulatory compliance auditor for banks. In addition, she writes comics and artist reviews at <a href="http://www.cosplayconnectuniversity.com.She" rel="nofollow">www.cosplayconnectuniversity.com.She</a> works in order to support knitting, comics, tattoo, and museum membership addictions. She has one dog, one husband, and one son who all live with her just outside of Hartford, CT.

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2 days ago
Overland Park, KS
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