Chloe Ramirez
A high BMI is one of the underlying health conditions that can qualify you for a vaccine. The US Centers for Disease Control and Prevention lists obesity as an underlying medical condition, defining it as a body mass index of 30 or higher but less than 40. However, a high BMI does not necessarily indicate poor health. BMI is a simple calculation based on weight and height that does not account for body composition. For example, athletes with a lot of muscle may have a high BMI but be extremely healthy. Nonetheless, a high BMI can be a risk factor for severe COVID-19 outcomes, and it is a standard measure used by health authorities to determine vaccine eligibility.
| Characteristics | Values |
|---|---|
| Body Mass Index (BMI) | Over 25 kg |
| Overweight | BMI of 25-29 |
| Obese | BMI of 30 or higher |
| Extreme/Severe Obesity | BMI of 40 or higher |
| Qualifying Conditions | Overweight or obese |
| Qualifying States | D.C., Virginia, Maryland, Georgia, Florida, Wisconsin |
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What You'll Learn
Obesity and a BMI over 30
Writer Emma Specter shared her experience of realizing that her BMI qualified her to get the vaccine. She initially felt hesitant and uncomfortable about taking the vaccine, especially as someone who identifies as fat and has experienced fat phobia from doctors. However, she ultimately decided to take the opportunity to get vaccinated, recognizing that she is entitled to healthcare like everyone else.
Specter also acknowledged that while she qualified based on her BMI, she would prefer that essential workers or individuals in harder-hit areas receive the vaccine first. She emphasized that she did not make the rules and is simply taking advantage of the opportunity presented to her.
It is important to note that BMI is a faulty indicator of health, and individuals should consult with healthcare professionals for personalized advice regarding their vaccine eligibility and overall health.
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Overweight and a BMI of 25-29
As per the US Centers for Disease Control and Prevention (CDC), a Body Mass Index (BMI) of 25 to 29.9 is considered overweight.
Having a high BMI may qualify you for the COVID-19 vaccine, but it does not necessarily mean you are unhealthy. Assessing your BMI is a quick way of indirectly measuring the amount of fat in your body. However, BMI is not always an accurate measure of health and can be problematic. For example, many football players have a BMI of 30 or above but are extremely healthy due to their muscle mass.
In Wisconsin, health officials have opened up COVID-19 vaccine eligibility to people with a BMI between 25 and 29.9. This is because some research has found a link between high BMI and more severe COVID-19 cases. According to the CDC, being obese may triple the risk of hospitalization from a coronavirus infection, and the risk of death from the virus increases as BMI increases.
If you are unsure if your high BMI is due to fat or muscle, it is recommended that you see a weight-loss specialist for specific tests. It is possible to lower your BMI through diet and exercise.
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Faulty health indicator
Body Mass Index (BMI) is a formula that uses height and weight to measure body fat. It was developed in the 19th century by a Belgian astronomer as a population census tool. However, in recent times, it has been used as a metric for assessing people's health.
A Flawed Metric
BMI has been criticized as a flawed, crude, and overrated proxy for health. Firstly, it was developed based on white males and may not be valid for other racial and ethnic groups. For example, an Asian person may have a high BMI without necessarily being unhealthy. Secondly, it does not consider the distribution of fat around the body. Abdominal fat, for instance, affects organs like the kidneys, liver, and heart more severely than fat around the hips. Thirdly, it does not distinguish between body fat and muscle content. As muscle is denser than fat, a muscular person may have a high BMI without being unhealthy.
Negative Consequences
The use of BMI as a health metric can lead to negative consequences. Weight-based shame may cause patients to delay or avoid medical care. It can also introduce mistrust into the doctor-patient relationship and lead patients to disregard medical advice. Furthermore, doctors may miss diagnoses because they wrongly attribute symptoms to weight.
Health Paradox
Recent studies have shown that obesity may protect against death from all causes, as well as death due to stroke, heart failure, and diabetes. This has been referred to as the "obesity-mortality paradox". Additionally, people with obesity have been found to have better post-surgical short-term survival rates than patients of normal weight. These findings suggest that the true impact of obesity may not be fully understood, and that health is influenced by a complex mix of factors beyond weight.
Alternative Indicators
Instead of focusing on BMI and "ideal weight", individuals should prioritize health-promoting behaviors such as spending time with loved ones, engaging in physical activity, and reducing smoking or vaping.
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Prioritisation discomfort
The COVID-19 vaccine has been made available to people with a Body Mass Index (BMI) of 25 or higher in some states and pharmacies. This has resulted in some people feeling uncomfortable about prioritising their vaccination over others. Some people have expressed that they would rather redirect the vaccine to essential or healthcare workers, or those who cannot work from home. This discomfort may be exacerbated by the perception that BMI is a faulty indicator of health.
In addition, individuals with a BMI over 25 may face challenges in obtaining the vaccine due to varying policies and requirements across different pharmacies and states. Some pharmacies may require a prescription or proof of eligibility, while others may not. This inconsistent landscape can create confusion and uncertainty for individuals seeking the vaccine.
Furthermore, there are concerns about fat phobia in the medical community, with doctors being accused of perpetuating negative attitudes towards overweight individuals. This may contribute to feelings of discomfort or hesitancy among those with a high BMI who are seeking the vaccine.
To address these concerns, it is important to recognise that BMI is just one factor among many that contributes to an individual's overall health. While it can be a useful indicator, it does not provide a complete picture of a person's health status. Additionally, individuals should not feel guilty or hesitant about receiving the vaccine if they meet the eligibility criteria. By getting vaccinated, they are not only protecting themselves but also contributing to the broader public health effort to control the spread of COVID-19.
It is also worth noting that the eligibility criteria for the COVID-19 vaccine are determined by health authorities based on the current understanding of risk factors and the need to protect vulnerable individuals. As such, individuals with a BMI over 25 should not feel responsible for the prioritisation decisions made by health authorities.
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Fat phobia in the medical profession
In some states in the US, people with a body mass index (BMI) of 30 or above now qualify for the COVID-19 vaccine. This has brought to light the issue of fat phobia in the medical profession.
Fat phobia, or weight stigma, is a pervasive phenomenon in contemporary societies, including healthcare settings. Many healthcare providers exhibit fat phobic attitudes, which manifest as weight bias, inappropriate comments, poorer treatment, and misdiagnoses. This can lead to alienation, triggering, and traumatization of patients with higher-weight bodies, resulting in harmful consequences.
Research has shown that more than half of women with larger bodies have experienced medical fat phobia from healthcare professionals, including inappropriate weight-related comments and barriers to receiving treatment. Furthermore, 40% of treatment providers have admitted to having negative attitudes toward people with higher-weight bodies. This weight stigma can lead to healthcare avoidance, late diagnoses, and rapid disease progression. For example, higher-weight women are less likely to be screened for cancers and are more likely to die from cervical and breast cancer if diagnosed.
Fat phobia in healthcare settings can also take the form of structural discrimination, such as inadequate medical facilities and equipment that are not designed with consideration for larger bodies. This can create physical barriers for patients and contribute to inaccurate diagnoses. Additionally, interpersonal relationships with healthcare professionals can be strained due to internalized negative stereotypes, compromising the quality of care and reinforcing a sense of guilt in patients.
It is important to address medical fat phobia and create a size-friendly environment to ensure that all patients receive equitable and respectful healthcare. This may involve educating healthcare providers about the complexities of weight and health, challenging weight stigma, and advocating for inclusive medical equipment and facilities. By doing so, we can reduce the harmful impacts of fat phobia on the physical and mental health of individuals with higher-weight bodies.
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Frequently asked questions
BMI stands for Body Mass Index, which is a calculation based on weight and height.
According to the CDC, you are overweight if your BMI is over 25kg and obese if your BMI is 30 or higher. People with a BMI of 25 or higher can qualify for the COVID-19 vaccine in some states.
Obesity is a risk factor for severe illness from COVID-19. The CDC released a study showing that out of COVID patients hospitalized and placed on ventilators, 28% were overweight and about 51% were obese.
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