Rebecca O’Neal did not believe she was eligible for a Covid-19 vaccine. She hadn’t realized that her turn had come. Last week, when she checked the eligibility requirements for the state of New York, she noticed the body mass index on the list.
The body mass index, or BMI, is technically a measure of obesity. The quantifier was developed in the 1930s by Metropolitan Life Insurance Company to assess risk. Since BMI is a formula that does not take into account several important factors, such as where the body fat is or whether a vital organ is surrounded by fat, experts say the indicator should be analyzed with caution. Still, a BMI that indicates obesity has been a source of agitation for people who believe their doctors used it to discriminate against them because of their weight.
O’Neal, a 34-year-old comedian and writer from Brooklyn, didn’t worry about that at the moment. She calculated her BMI (it is essentially her weight compared to her height), found that she reached that technical limit for obesity and made an appointment for a vaccine for the same day. She received her first dose in the late afternoon.
“I didn’t know my BMI was 30,” said O’Neal in a telephone interview. “I told a lot of jokes about it on Twitter, but it was a relief that I was eligible.”
Relying on a BMI to assess the risk of serious illness is complicated. Many healthy people still fall into the “overweight” category based on their body proportions, with no distinction made between bone density, muscle mass and body fat.
This is particularly the case for women, black adults and low-income people who make up the majority of Americans who have been diagnosed with obesity by these standards. This has a lot to do with the fact that the original calculation was developed by and for white men.
For many, using their misleading high BMI to be vaccinated is a difficult decision.
As Emma Specter put it in Vogue, writing about her decision to get a vaccine based on her BMI qualification: “A health metric that has long been questioned by fat activists and medical experts can actively benefit fat people for the first time.”
Many other people are making the same decision – and posting about it online.
Some struggled to find out whether it was ethical to receive a vaccine based on a metric that could have little influence on the risk of serious illness.
“Caring for the sick, the elderly and health professionals, I understand all of this – but at some point they should have opened it up for anyone who can grab it,” Raffaele Rispo, 38, a barber from Saratoga Springs, NY who recently received a vaccine because of your BMI, said in an interview. “I understood that the older, the sicker they should get it first – but when they changed, I was happy.”
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Mr. Rispo did not see his parents, who live two and a half hours away from him, nor his 15-year-old son who also lives a few hours away, in a year. He was ready to return to “some normality”, although he understood that BMIs are unreliable, he said.
Although not reliable, a BMI can serve a purpose; it can be used to track weight categories that can lead to health problems, according to the CDC, but it is not a diagnosis of body fat or a person’s health.
“BMI alone is not a big measure,” said Dr. Fatima Cody Stanford, a specialist in obesity medicine and nutrition at Harvard Medical School. “It does not tell me if it is the mass of fat that is causing the inflammation. It doesn’t tell me if it’s the weight of the water, it doesn’t give me those kinds of specific details. “
For those who meet the BMI requirements for the vaccine, this measurement presented a rare opportunity. William Antonelli said that as soon as his sister realized she was qualified for the vaccine because of her BMI, she made an appointment for him too. A few days later, Mr. Antonelli, 24, an Insider editor, received his first injection of vaccine.
“When it comes to a disease like this, there is really no wrong person to vaccinate,” he said. “The problem is not that I apply for something I’m eligible for, but the launch. The issue is in the government system that led us to this point ”.