The Trouble With Tables

Lately I have been receiving an increasing number of messages from women asking for advice about their weight/height, both on the boards and via email. Careless comments on this subject can be harmful to people susceptible to, or struggling with, eating disorders.

I have usually responded to such inquiries by simply noting that healthy weight is a highly individualized concept dependent upon many factors, and encouraging people with such concerns to seek competent medical advice. Unfortunately, I have occasionally voiced opinions on this subject based upon my recollection of standard weight-height charts and anecdotes about various actresses. That was very wrong, and for this error in judgment I humbly apologize. For the reasons stated below, I am now convinced that the mere mention of such numbers to persons with eating issues is, in the absence of face-to-face consultation with a qualified medical professional, fraught with danger.

“We do not allow our members to exchange anything number-related (weights, sizes, BMI [body mass index], calories, etc.) because it only feeds into the “competitive” nature of the illness, or the feelings of worthlessness based on a number,” writes Amy Medina of the Something Fishy Website in an email. “It takes away from the true purpose of the discussion – to explore the feelings underneath the symptoms. We have some strict policies in place, one of which is the “no numbers” rule. Another is related to medical questions: we don’t allow them at all. We have always stressed that even if we could answer the questions accurately, or diagnose them, it would be dangerous and unethical to do so, if for no other reason than their problem cannot be treated online.”

After querying several knowledgeable professionals and consulting with Suite101.com management, I have decided to adopt for this topic page a modified version of Something Fishy’s message boards rules. Please read it now.

Standardized weight and height charts are, at best, a rough guide to well-being. Over-reliance upon them can be hazardous. “They are not a reflection of what is healthy, but rather a reflection of actuarial data from insurance companies on mortality rates,” writes Bryan Gusdal, M.A., in an email. Mr. Gusdal is Director of the Westwind Eating Disorder Recovery Centre in Brandon, Canada. “They do not take into account lifestyle components such as smoking or exercise. BMI measures are a little better, but not much. Barry Saunders was a leading rusher in the NFL, and his BMI was 30. Was he obese? Was he unhealthy? He certainly was fit. Standards of health might be a better measure than standards of mortality rates. They just are not measuring the same thing. Glenn Gaesser’s Big Fat Lies (Fawcett Columbine 1996) has a good discussion on the origins of height-weight charts, their shortcomings and misuse. Questions of lifestyle would be more appropriate in terms of health, without so much reference to weight. The weight issue is more focused on appearance than it is on health, even though it is often presented as a health concern.”

Mohey Mowafy, Ph.D., Professor and Director of the Didactic Program in Dietetics at Northern Michigan University, concurs. “I have been teaching human nutrition, including a course on “body weight: its meaning and management,” for more than 25 years, and have never lived a semester without living the lively and often controversial discussion of the weight and height tables. The tables are good guidelines, but totally useless if perceived as axiomatic standards. They prove most valuable with individuals having the largest deviations from their ranges. Such cases certainly require a closer look. The tables are used often because they are easy and cheap. I teach my students to use them as a part of a comprehensive assessment that includes body composition and muscle mass, plus the usual family and personal health history, dietary and activity patterns, lab results, if and when needed, and whenever feasible, an assessment of the individual’s motives and motivations to change his or her weight.”

I have, to the best of my knowledge, deleted all messages appearing on these boards which violate the new rules which I have developed for this topic page. I will continue to monitor the messages accordingly. If I have overlooked any, or if you have additional concerns, please inform me. I very much regret having to impose any form of censorship, but under the circumstances, the potential for harm from such missives outweighs any possible benefits.