– Why do doctors care so much about your BMI when it’s has been proven to be such a flawed metric for ones actual health?
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Doctors, like any other profession, can vary in quality.
Really good doctors will look at all of your body’s data. They understand BMI is only useful in certain situations and will discuss it in those situations. For example, body builders don’t follow the model BMI tries to build and tend to show up as “obese”. Likewise, some people with disorders will likely never have a “healthy” BMI without making unhealthy changes.
Really bad doctors don’t put in that much effort. They take the vitals they have to, poke around, and tell you something that may not be the best advice. Sometimes they miss important signs of underlying conditions and, if you don’t find a better doctor, you may not catch that condition in time.
For example, I read a story about a woman who knew she had some troubling symptoms, but no matter how many times she went to her doctor he told her she needed to lose 40 pounds. There weren’t other doctors in her area and specialists wouldn’t see her without a referral. Her doctor refused to refer her because he was so sure her weight was the problem.
So she lost 40 pounds. He smiled and said, “I bet you feel better now, right?” She didn’t. So then he did some tests, and discovered she had stage 2 ovarian cancer. That would’ve been found if he’d done the tests months earlier.
Bad doctors get away with this because it doesn’t count as malpractice: they can’t be held responsible for not reporting conditions they haven’t seen, and it’s hard to prove there was evidence they should’ve done more extensive tests. There also aren’t really enough doctors. In my area, almost every practice has a 3-6 week lead time for appointments and most aren’t taking new patients. The last time I had to find a new specialist I had to make 9 calls before I found one that could work me in 2 months later. That means a lot of people have to stick with a “not the best” doctor because it’s very hard to find a new one. For capitalism’s “bad service means you go out of business” to take place, people have to have an easy way to choose better service.
So it’s not that doctors in general care so much about BMI. Good ones see it as a tool with a limited use. Bad ones are just taking advantage of their patients’ limited amount of recourse. They’re backed up by society, in general, having little empathy or sympathy for people who are overweight. We like to make fun of overweight people. We consider them lazy and assume if they’d make “better choices” things would get better. So a lot of doctors get a free pass to use weight to write off their patients’ concerns.
Mine did it too. Guess what? I’ve lost 43 pounds over the last year and almost none of my symptoms have changed. I do feel better, I just still have the same problems 3 different doctors have told me don’t exist. If you dig around and read accounts of people who have rare disorders, it’s not uncommon for some people to spend years visiting dozens of doctors before one decides, “Let’s just start testing for everything until we find something.” For some reason, most doctors give up after the obvious tests don’t turn anything up. “You’re overweight” is a good way to justify that.
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