OPINION:
Like 25 per cent of the British population, my body mass index (BMI) declares me “obese”. And like at least 95 per cent of the population, I roll my eyes whenever BMI is used as a health measure.
So, I was encouraged by the news this week
I’m proof that it really is possible to be ‘fit but fat’
By Isabel Mohan
Daily Telegraph UK·
8 mins to read
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"My resting heart rate is 50: official athlete territory. I just don’t look like one, as the world is at pains to remind me." Photo / Dulcey Lima, Unsplash
Opinion by Isabel Mohan
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Over the years, thanks to some ill-advised yo-yo diets, two babies and a fair bit of Dairy Milk, my weight has fluctuated between “pretty average” and “quite hefty actually”. At my slimmest – after a bonkers diet when I literally didn’t eat real food for six months – I was a size 10 but still technically overweight and, at my heaviest, I was well into “obese” and a size 18.
Right now, aged 42, my BMI is 31 – the lower end of obese – but I eat a balanced diet and I’m the fittest I’ve ever been. And my dress size is pretty average for the UK. I’m a 12 on top and 14 on the bottom, which is probably not what people think of when they hear “obese”.
As far as my diet goes, during the week, I typically eat low-sugar granola and Greek yogurt for breakfast, salmon and eggs for lunch, and dinner is usually a stir-fry or homemade curry, and I snack on fruit. On the weekends I’m a bit looser, I might have a takeaway or meal out with friends and a pain au chocolat after parkrun. I drink alcohol twice a week – it was more like six times a week in my 20s.
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Last month I ran my third half marathon in two years, and, terrifyingly, I’ve just signed up for next year’s London Marathon. I run four times a week and strength-train a couple of times too. Yes, I’m that insufferable school mum head to toe in Sweaty Betty, smugly dashing from drop-off to bash out a quick 5K before work.
This hasn’t always been the case. I didn’t exercise until I was 39, when lockdown made me desperate to escape being trapped inside with two kids. I went to extreme measures: I downloaded Couch to 5K. Now I’m a fully-fledged exercise bore, yet still obese.
Despite the extra junk in my trunk, my blood pressure is lower than when I was slimmer – it skyrocketed during pregnancy and remained high through various weight fluctuations. It was only when I got fit that I was taken off medication.
My blood sugar and cholesterol are fine and my resting heart rate is 50: official athlete territory. I just don’t look like one, as the world is at pains to remind me.
A couple of months into my exercise epiphany, I was out jogging when a white van approached containing two men. I’ve named them Steve and Steve and they looked exactly as you would imagine. “Keep it up fatty!” they bellowed before zooming off, cackling.
I gave them the finger – not very classy, sorry Mum – and finished my 8K run feeling furious. I could have cried and never shown my wobbly Lycra-clad bum on the mean streets of Catford again, but instead I followed their advice. I now write a newsletter called Keep It Up Fatty! and while Steve and Steve haven’t signed up, I’ve heard from hundreds of people who’ve been shamed for exercising because they don’t look like Olympians.
The new research shows that fat distribution is a better indicator of health than BMI, which is why more women, who store fat on their hips and thighs, than men, who gain weight around their bellies, are “metabolically healthy”. I’m 5ft 4in and curvy with a lot of muscle – but it would be optimistic to suggest that’s the only reason I weigh a lot. I also don’t like the idea that I’m “good fat” in a way I can’t control because it’s unfair on those with different body shapes.
The truth is, using BMI as a yardstick makes life easier for overworked medics, but as Dr Joshua Wolrich, author of Food Isn’t Medicine and advocate for the Health at Every Size movement, says, it’s too often used as an excuse to dismiss patients.
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“If we didn’t have such an issue with weight stigma we would be able to have more objective conversations,” he explains. “A doctor might take a look at someone’s BMI and say “your weight is putting you at risk, go on a diet and come back in six months”, when actually the impact of the diet itself on a person’s internal organs and health can often do more harm than good due to inevitable weight-cycling having potentially harmful impacts on body fat distribution.”
Like the thankfully growing numbers of modern doctors who’ve cottoned on to the limitations of BMI, Dr Wolrich is at pains to emphasise that BMI was never designed for individuals, but to make general observations about populations. He believes the fact that it can now dictate the access people have to healthcare is outrageous, with many “obese” adults prevented from adopting children or accessing fertility services.
Dr Zoe Watson, GP and founder of Wellgood Wellbeing, agrees: “BMI doesn’t account for differences in body composition between different genders and races and doesn’t actually measure body fat in any way at all. It doesn’t even account for breasts in women.”
The problem is that it’s hard to find meaningful alternatives. In an ideal world, doctors would assess patients individually, but it’s not realistic. “Health is so much more than what you weigh or what your body fat percentage is,” Dr Watson adds. “It’s a complex interaction of genetics and environment. The widely accepted ‘alternative’ to BMI is waist circumference, but even that is a pretty crude measurement, as all sorts of things can affect it, including the time of day you measure it.”
But just having a threshold at all feels shaming and arbitrary. After all, a bout of food poisoning would push me down into being merely overweight, but would I be any healthier?
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My own habits prove it is possible to be obese by eating slightly bigger portions than my slimmer friends, or having three G&Ts to their two. A lot of my circle worry that they’re “skinny fat” – they devour as much wine and chocolate as me and never exercise but, for whatever reason, still fit into size 8 jeans. If they see their GP with aches and pains or hormonal trouble, they’re not given patronising advice to eat less and move more, which is so often the case when we’re bigger.
Luckily, running is amazing for my body confidence. When I go to my local parkrun on a Saturday morning, I see a huge variety of bodies and don’t feel like I stand out.
Sure, those who run 5K in 15 minutes tend to look stereotypically athletic, but at the less elite end of the scale, normal runners of all shapes and sizes are crushing it. It might sound silly, but I wish we treated people more like dogs – we don’t expect pugs to look like whippets, or measure them by the same standards.
If we want to solve the UK’s health problems, dividing us into “big equals bad” and “small equals good” is not the solution. If we weren’t so fixated on weight, more people might feel confident to be active. Celebrating fitness across different sizes isn’t glorifying obesity, but instead empowers us to see that being active is possible, crushing the stereotype that overweight people are lazy and gross.
In an ideal world, would I like to lose weight? Of course, as a teenager of the 1990s, I’m conditioned to want to be slim and I worry when I see headlines declaring obesity a greater cause of cancer than smoking for women my age. But getting fitter has encouraged me to strive for strength and stamina rather than unrealistic aesthetic ideals.
Plus, the only way for me to lose weight significantly seems to be to live on kale and run screaming if I’m in the same room as a slice of sourdough. And that’s not the greatest recipe for fitness or a happy, balanced life.
- Isabel Mohan is a lifestyle and entertainment reporter at the Daily Telegraph
