Thoughts on our approach to weight/BMI?

edit: I think this is a little too focused on me or at least comments are so I’m going to take a few wee bits out.

I’m a final year student, really interested in discussion on this subject, but I don’t have real working experience with it, more from uni lectures on more systemic causes of obesity and my own experiences as a patient, but I generally think our approach to patients weights are far too black and white, can this realistically be improved?

I’m a UK size 10, 5’8, wear a small uniform, am a sporting professional, keen hiker, very fit and active, eat healthily and my usual GP who knows me and my history doesn’t want me to lose any weight… but my BMI puts me as overweight, very very nearly obese. There’s never any questioning about why my BMI is high, this seems problematic. Also I strongly believe we should never be using BMI to make medical decisions, it’s poor science at best. I’d support using it in conjunction with other measurements like waist to height ratio, and surely that would provide a better insight into a patient… so why don’t we use more than just BMI?

Especially women, are frequently fobbed off because of their weight, this is really common in endometriosis, who face massively delayed diagnosis already, and other general pain patients, and endo has been shown to cause weight gain and trouble losing weight, it seems to be used as a fob off thing a lot, listening to patient experiences, this is almost always the first thing you hear.

The increasing rates of depression, and I strongly believe this will only keep increasing, and growing inequality/poverty rates, again increases poor nutrition and weight gain. Yet I don’t think this is brought up enough.

Care for ED patients is generally not great, and even then, I don’t think there is nearly enough awareness about EDs that cause weight gain, like BED.

I just generally feel like obesity and the increasing weight of the population in general is being approached medically with the nuance i think it needs, especially if we’re going to claim to always use patient centred, individualised, holistic care. For a lot of people, it’s not as simple as eating less and moving more, but the extenuating circumstances I don’t think are explored or talked about enough. Then people turn to things like the weight loss jags and are seemingly still shamed? Do you think this can be improved? Is there really any push to improve it? Or change approaches?

What are your thoughts on it? Does it need changing?

Thanks! Genuinely interested in more experienced thoughts on this!