Body Mass Index

Baroness Thornton Excerpts

Thursday 22nd April 2021 Grand Committee

[Baroness Thornton (Lab)]

My Lords, I congratulate the noble Lord, Lord Addington, on this debate, which has already raised many interesting issues. Indeed, the report of the Women and Equalities Committee into body image is not new. Over 40 years ago, Susie Orbach wrote Fat is a Feminist Issue; she challenged body mass index as a measure of—as she said—“nothing useful” and pointed out how it affected women’s self-image. On the 40th anniversary of FIFI, as many of us know it, she said:

“When you grow up absorbing the idea that food is quasi-dangerous, it is hard to know how to handle it. There are no end of experts selling their wares whose books and products end up generating enormous profits … So, too, with other food and diet fads. The desperation that exists to be at peace and dwell in our bodies clashes with the knowledge that such schemas promote or reinforce confusion about appetite and desire.”


The fact is that, 40 years on, it is still pretty grim:

“It’s a story of … destabilising the eating of many western women and exporting body hatred all over the world as a sign of modernity”,


as a way of medicalising and pathologising

“people’s relationship to food and bodies so successfully that vast industries would grow up to treat problems that these industries had themselves instigated.”

What is clear from this short debate is that it should come as no surprise that BMI as a single measure would not be expected to identify cardiovascular health or illness; the same is true for cholesterol, blood sugar and blood pressure. As a single measure, BMI is clearly not a perfect measure of health, but it is probably a useful starting point for important conditions when a person is overweight or obese.

The Select Committee said that it was

“not satisfied with the use of BMI as a measurement to evaluate individual health.”

On the other hand, as other noble Lords have said, Diabetes UK says that it provides

“valuable information for care focused on individuals that doesn’t discriminate against anyone.”

I dispute that, but it also goes on to say that it has been an important tool for monitoring the population’s health and informing policy decisions and has been fundamental in the rollout of the Covid population risk assessment, which identified 1.7 million people at increased risk of hospitalisation and death from coronavirus. Without that use of BMI, a population-based intervention would not have been possible.

The challenge for the Minister is how to reconcile these issues. I look forward to hearing his answer.