Damaged: Perfect Becomes the Enemy of Good

Only 27 percent of adults in the U.S. have a BMI in the range that CDC labels as “healthy or normal.” Most people think that diet and exercise is the best answer for obesity. They think this even though just about everyone with obesity has tried that prescription and most find that it doesn’t fix their problem. Some of the evangelists are more specific. Vegetarians feud quietly with vegans over who has the more perfect diet. Diet evangelists argue that people are rarely so “damaged” that they can’t achieve perfect health by intermittent fasting cutting carbs.

But reality is not so tidy. Mortality is a fact and everyone, sooner or later, encounters health problems. So we have a choice. Either face the problems and deal with them as best we can, or deny them. When perfect is not possible, why pursue an option that is merely good?

BMI: A Scam?

Along these lines the New York Times latched on to a popular pastime – bashing BMI. Anybody can tell you that it is not a good unitary measure of health. Rather, it’s a useful tool for research as a crude surrogate for adiposity. Other measures are better, but more difficult to obtain. As a signal for a potential problem with adiposity, it’s not bad. However, it does not work well in isolation as a measure of individual metabolic health.

Alice Callahan talked with an epidemiologist, two physicians, a social psychologist, and a sociologist. She described the ways that people misuse BMI and reported that no one in her sample of five said it was a very useful measure of health. Some of them, she said, would indeed call it a scam.

We beg to differ. BMI is merely a number – neither perfect, nor such a damaged concept that it should be discarded. As with any number, humans must carefully consider how to use it appropriately.

Perfect and Damaged Goods

Perfection is a moving target. Aesthetic perfection is always subjective. Despite what you will read from various evangelists, there is no perfect diet. Nor is perfect health a reasonable expectation. Our bodies will fail each of us in ways large and small. Yet these bodies are good because they give us life. The best option is to embrace that gift of life and pursue health that is good enough, though it will never be perfect.

Click here for Callahan’s essay on BMI as a scam and here for a different perspective. For perspective on why there is no perfect diet, click here and here.

The Perfectionist, painting by Grant Wood / WikiArt

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May 23, 2021