We live in a society where physical size and shape are given a lot of attention. Media portray what is considered ‘normal’ with little consideration of the impact this can have on children, adolescents and adults self-perception and feelings of worth.
We live in a society where physical size and shape are given a lot of attention. Media portray what is considered ‘normal’ with little consideration of the impact this can have on children, adolescents and adults self-perception and feelings of worth. This is especially evident in television commercials and brochures for clothing, where tall, lanky models are displayed as the norm, and little variation in body size is seen. The media message of ‘attractiveness’ is neither authoritative nor has validity. The reality is that there is no ‘ideal body’ and that a wide variation in both body size and shape can be considered ‘normal.’ Genetics plays a major part in how we look, in appearance, size and shape.
Healthcare professionals like numbers and the way we measure an individual’s size is by using various tools including height, weight, Waist Hip Ratio (WHR), skinfold thickness and Body Mass Index (BMI). Children usually have their length (height), weight and head circumference measured to ensure growth is following an acceptable range. In adults, usually, the focus changes from growth charts, to risk factors for metabolic syndrome, obesity and diabetes. Therefore, a visit to the doctor may result in a measurement of weight and other surrogate measurements of body fat (WHR, skinfold thickness and BMI).
The BMI is often used as an inexpensive and easy screening method for weight category. It is moderately correlated as a measure of body fat and strongly correlated with metabolic disease. BMI is calculated as the person’s weight (kilograms) divided by the square of the height (m2). There is a range of possible values for the BMI and these can be seen in the table below:
|BMI (kg/m2)||Weight status|
|less than 18.5||underweight|
|more than 30||obesity|
The clinical utility of the BMI is that it allows the identification of risk. Obesity confers risk for many diseases and conditions including hypertension, high cholesterol, diabetes, coronary heart disease, gallbladder disease, osteoarthritis, some cancers and mental illness. Knowing your BMI is useful but there are some caveats. BMI is interpreted differently for children and teens. BMI may need adaptation for different populations (e.g. Asians). A high BMI can be due to high body fat but it can also be due to high lean body mass (muscle and bone), therefore it may not apply to athletes. Interpretation of BMI should be part of a complete health assessment by a trained healthcare professional.
Perception of body image is important and can shape how we feel. A healthy body image will result in feeling happy and content with the way you are. An unhealthy body image can cause stress and lead to unhelpful behaviours. Some eating disorders are linked to an unhealthy body image, for example, binge eating disorder, anorexia nervosa (Anorexia) or bulimia nervosa (Bulimia). Anorexia is characterised by a distorted body image (seeing themselves as overweight when in fact they are underweight), an intense fear of gaining weight and reduced caloric intake associated with rapid weight loss. People living with anorexia typically have a BMI of less than 18.5. In this instance, knowing BMI is a useful way of charting someone’s response to therapy for anorexia.
Tools like BMI help healthcare professionals manage risk in populations in a systematic way. There are many mixed messages on TV, media and society regarding body size and shape. Having a positive self-image is important for mental wellbeing. You are not defined by the way you look. Feeling good about yourself and being healthy is what we should all strive for.
The Butterfly Foundation (https://butterfly.org.au/)
CDC. Body Mass Index (BMI)
The national eating disorders collaboration (https://www.nedc.com.au/)
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