The Body Mass Index (BMI) is widely used as a measure of health, yet its origins and applications reveal deep-rooted biases in scientific racism, sexism, and eugenics. This report explores the historical development of BMI, its connection to social hierarchies, and its role in fatphobia, reproductive rights, and capitalist exploitation. It also incorporates gender and fat studies, particularly the work of Amy Erdman Farrell in Fat Shame: Stigma and the Fat Body in American Culture (2011).

1. The Origins of BMI and Its Eurocentric Basis

The Body Mass Index (BMI) was developed in the 1830s by Belgian mathematician Adolphe Quetelet. Originally called the Quetelet Index, it was created to define the “average” body type for European men rather than as a tool for assessing health (Eknoyan, 2008).

Quetelet was not a physician; his work was statistical, and he never intended BMI to measure individual health.

The BMI formula assumes that weight and height increase at a constant rate, which does not reflect human body diversity.

White European men were the standard for BMI calculations, while other ethnicities and genders were marginalised in medical classifications (Eknoyan, 2008).


Despite these limitations, BMI was later adopted by governments and medical institutions as an objective health measure, despite lacking scientific justification.

2. Scientific Racism, Eugenics, and the “Perfect” Body

The 19th century saw the rise of scientific rationalism, replacing the rule of monarchy and the Church with science and industry. However, these developments also reinforced scientific racism and eugenics—attempts to define which bodies were “superior” or “inferior”.

Physiognomy and Phrenology: Pseudosciences like phrenology (the study of skull shape) and physiognomy (the belief that facial features indicate intelligence) were used to justify racial and gender inequalities.

Cesare Lombroso (1835–1909): This Italian criminologist argued that criminality could be predicted by body shape. His book Criminal Woman, the Prostitute, and the Normal Woman (1893) claimed that women with larger thighs and buttocks were destined to become prostitutes (Lombroso & Ferrero, 1893).

Georges Cuvier (1769–1832): A French naturalist, Cuvier ranked Black people lower on the “evolutionary scale,” reinforcing racist stereotypes in anthropology (Gould, 1996).

Fatness as a “Primitive Trait”: In early anthropology, larger bodies were associated with non-European populations, reinforcing the belief that thinness was civilised, while fatness was animalistic (Strings, 2019).


This thinking persists in modern medicine, where BMI classifications pathologise non-white and female bodies by holding them to white, male-centric standards.

3. The Medicalisation of BMI and Weight Stigma

Although BMI was not designed as a health tool, it was adopted by the National Institutes of Health (NIH) and the World Health Organization (WHO) in the 20th century.

In 1998, the NIH lowered BMI thresholds, which suddenly reclassified millions of Americans as overweight or obese overnight (Oliver, 2006).

Elite athletes and muscular individuals were now considered overweight due to BMI’s flawed assumptions.

Women’s fat distribution (thighs, buttocks, and breasts) is naturally higher, yet BMI ignores sex-based differences in body composition (Nuttall, 2015).


This shift aligned with the financial interests of the weight loss, pharmaceutical, and fitness industries, which profit from diet culture and medicalised fatphobia.

4. Gender and Fat Studies: Amy Erdman Farrell’s Analysis

Amy Erdman Farrell’s book, Fat Shame: Stigma and the Fat Body in American Culture (2011), provides a crucial feminist and cultural analysis of how fatness is portrayed, controlled, and ridiculed in society.

Fatness as a Symbol of Moral and Social Failure: Farrell traces the historical development of fat stigma and how it is linked to moral panic and social control.

Media Representation and the Male Gaze: The media reinforces thinness as a feminine ideal while depicting fat women as lazy, undesirable, and lacking self-control.

Fatphobia and Capitalism: The $90 billion weight loss industry relies on shaming fatness to sell diets, pills, and fitness programs.


Farrell argues that fat stigma is not about health—it is about maintaining social hierarchies that benefit capitalism and patriarchy (Farrell, 2011).

5. The Restriction of Fat Women’s Reproductive Rights

Women with higher BMIs face barriers to reproductive healthcare, particularly in IVF access and adoption eligibility.

IVF Restrictions in the UK and US

The UK’s National Institute for Health and Care Excellence (NICE) guidelines deny IVF to women with a BMI over 30 (NICE, 2013).

In the US, private clinics refuse IVF to women with a BMI over 35, despite no clear evidence that weight loss improves fertility (Pandey et al., 2010).

Adoption Discrimination

Many adoption agencies consider BMI as a factor, assuming fat parents are unfit to care for children (McPhail et al., 2016).


These policies align with historical eugenics, where fat people were deemed unfit to reproduce.

6. Conclusion: Fatphobia as a System of Social Control

The BMI is not a neutral health measure—it is a tool of racism, sexism, and economic exploitation. The control of fat bodies serves:

Medical institutions, which enforce weight stigma.

Capitalism, which profits from diet culture.

Patriarchy, which ties women’s worth to thinness.


Reproductive restrictions, BMI-based discrimination, and the erasure of fat women all show that fatphobia is not about health—it is about power.

References

Bergman, B. (2009). The Nearest Exit May Be Behind You. Arsenal Pulp Press.

Eknoyan, G. (2008). Adolphe Quetelet and the BMI. Nephrology Dialysis Transplantation, 23(1), 47-51.

Farrell, A. E. (2011). Fat Shame: Stigma and the Fat Body in American Culture. NYU Press.

Flegel, K., et al. (2013). Overweight, Obesity, and Mortality: Finding the Optimal BMI. JAMA, 309(1), 71-82.

Gould, S. J. (1996). The Mismeasure of Man. W. W. Norton & Company.

Guthman, J. (2009). Weighing In: Obesity, Food Justice, and the Limits of Capitalism. University of California Press.

NICE (2013). Fertility: Assessment and Treatment for People with Fertility Problems. National Institute for Health and Care Excellence.

Orbach, S. (1978). Fat is a Feminist Issue. Paddington Press.

Strings, S. (2019). Fearing the Black Body: The Racial Origins of Fat Phobia. NYU Press.