From BMI to Whole-Person Care: A Shift in How We Define Health

Aubry Orlino
4 days ago
5 min read

We’ve all heard it — “Check your BMI to see if you’re healthy.” For decades, that simple equation of weight and height has shaped how society — and even healthcare — defines what’s “normal.” But what if the very number we’ve been taught to trust doesn’t actually reflect our health at all?

For many individuals — particularly those recovering from eating disorders — BMI can distort reality, fueling shame and distraction instead of supporting healing and balance.

Why BMI Falls Short

BMI (Body Mass Index) is a mathematical ratio between weight and height, originally developed to assess population-level trends — not individual health. It doesn’t measure muscle mass, bone density, hormones, hydration, or body composition, all of which are critical indicators of physiological well-being. Two people can have the same BMI yet exist in entirely different states of health.

For example:

Person A may have a “normal” BMI yet experience nutritional deficiencies, hormonal imbalance, or chronic fatigue due to restrictive eating.
Person B, who falls into the “overweight” BMI category, may have optimal cardiovascular function, strong muscle tone, and stable energy levels due to balanced nutrition and physical activity.

“These differences highlight why BMI alone can’t define health — we’re all made differently. We all have different muscle mass and genetic components. BMI doesn’t take into account any of that” (Shelly Bar, MD, Glamour Magazine, 2025).

What We Should Pay Attention To Instead

A more accurate assessment of health should include metabolic, cardiovascular, and psychological factors, not just weight.

“Blood pressure tells us how hard your heart is working, when the heart is straining, it increases cardiovascular risk. There are plenty of people with normal BMI who have high blood pressure due to lifestyle factors, stress, or family history.”

“If you have high hemoglobin A1C, that can indicate risk for diabetes — a condition that affects nearly every organ in the body."

In other words, objective biomarkers such as blood pressure, glucose levels, lipid panels, and hormone balance offer far greater insight into health than BMI ever could (Shelly Bar, MD, Glamour Magazine, 2025).

What Does “Obesity” Even Mean?

“BMI only takes into consideration someone’s height and weight. It doesn’t measure a patient’s metabolic or psychological health, it really doesn’t tell me anything — except the level of weight stigma that is likely placed on them.”

We want to emphasize the importance of redefining obesity in a more nuanced, clinical way.

“We need to look at different measures to define obesity. GLP-1 medications have transformed obesity treatment by targeting hunger and insulin resistance,” she explains. “However, there are concerns in the Health At Every Size movement about long-term effectiveness and the risk of reinforcing weight-centric healthcare, which can lead to disordered eating. These medications should be reserved for cases where all other measures have failed, but they’ve sort of become the first line of treatment.”

This approach underscores the growing consensus among specialists: health must be understood as multifaceted — metabolic, emotional, and behavioral — not just numerical (Shelly Bar, MD, Glamour Magazine, 2025).

The Obesity Gender Gap

“When we look solely at weight, we’re really missing other important factors about the body. Women are juggling so much — careers, caregiving, and daily stressors. All of that impacts how they move, eat, and practice self-care.”

Chronic stress, hormonal shifts, and lack of recovery time can alter metabolism and cardiovascular health, independent of BMI. For women especially, this underscores the need for compassionate, individualized healthcare — not one-size-fits-all metrics (Shelly Bar, MD, Glamour Magazine, 2025).

A More Comprehensive Framework for Assessing Health

Clinicians and dietitians specializing in eating disorders now use a holistic approach, looking beyond BMI to understand each person’s unique needs. This includes:

Vital signs: Continuous monitoring of heart rate, blood pressure, and thermoregulation provides insight into cardiovascular stability and metabolic adequacy. For example, bradycardia or hypotension may indicate malnutrition or autonomic dysregulation in restrictive eating disorders.
Lab work: Comprehensive biochemical profiling — including electrolytes, renal and hepatic function, thyroid hormones, lipid panels, and micronutrient levels — allows clinicians to assess metabolic balance and detect potential deficiencies or endocrine disturbances associated with disordered eating behaviors.
Behavioral and Nutritional Patterns: Analysis of eating behaviors, physical activity, and coping mechanisms helps identify maladaptive patterns such as restrictive intake, binge–purge cycles, or excessive exercise. These insights inform individualized treatment plans aimed at restoring balanced and sustainable nutrition.
Psychological and Emotional Health: Evaluation of mood stability, body image perception, stress response, and resilience is essential in determining recovery progress. Emotional dysregulation, perfectionism, and self-criticism often play central roles in perpetuating eating disorders.

This integrative assessment approach provides a far more accurate representation of a patient’s health status than BMI alone. By combining physiological, metabolic, and psychosocial data, clinicians are better equipped to guide patients toward long-term recovery, sustainable nourishment, and holistic well-being.

Health Is More Than a Number

Recent updates from organizations such as the American Medical Association (2023) reinforce that BMI is an imperfect screening tool and should not be used as the sole determinant of wellness. True health is multidimensional — encompassing nutrition, metabolic function, mental health, and quality of life.

Someone with a “normal” BMI may still struggle with nutrient deficiencies or hormonal imbalance, while someone with a “higher” BMI may have excellent metabolic health and emotional stability.

The Takeaway

If you’re in recovery from an eating disorder — or supporting someone who is — remember this: your worth is not defined by a number. Healing means rebuilding trust in your body, restoring your relationship with food, and nurturing both physical and emotional well-being.

While BMI may serve as a starting point for population screening, it cannot capture the complexity of individual health. True wellness lies in balance, compassion, and sustainable self-care — not in arbitrary numbers.

To those on this journey: be patient, be kind, and celebrate progress in all its forms.

References

American Medical Association. (2023, June). Use of BMI alone is an imperfect clinical measure. American Medical Association. https://www.ama-assn.org/delivering-care/public-health/ama-use-bmi-alone-imperfect-clinical-measure

Harvard T.H. Chan School of Public Health. (2022). BMI: A poor metric for measuring people’s health. Harvard University. https://www.hsph.harvard.edu/news/hsph-in-the-news/bmi-a-poor-metric-for-measuring-peoples-health/

MacKenzie, M. (2025). What is obesity — and what it does and doesn’t tell you about your health. Glamour. https://www.glamour.com/story/obesity

National Institutes of Health. (2023). The science, strengths, and limitations of body mass index. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK594362/

Wu, Y., Li, D., & Vermund, S. H. (2024). Advantages and limitations of the body mass index (BMI) to assess adult obesity. International Journal of Environmental Research and Public Health, 21(6), 757. https://doi.org/10.3390/ijerph21060757

Sweatt, K., Garvey, W. T., & Martins, C. (2024). Strengths and limitations of BMI in the diagnosis of obesity: What is the path forward? Current Obesity Reports. https://doi.org/10.1007/s13679-024-00584-x