Pseudoscience in the Hospital
Image via Blue Tree Health
Pseudoscience.
The word itself invokes mystery. Seriously, who would believe in this mysterious brand of science over the tried and true version.
Well, I’m sorry to say that doctors would. Sometimes global health organizations too. And I won’t mince words, it’s kind of embarrassing. Just as a disclaimer, I don’t blame the doctors, I blame the people creating the standards for the training of those doctors. Yes, you should treat science that has not been tested in the era that it is being used with aggressive opposition too.
“But, Matthew, what are you talking about?” you ask. I’m talking about the infamous and ubiquitous Body Mass Index, of course.
Tell me if this sounds familiar. Your nurse asks you to take off your shoes and step on the scale to take your height and weight. Afterwards, you receive the snap diagnosis telling you that you’re underweight, average, or overweight. How are they making that determination?
Let’s take a closer look.
Lambert Adolphe Jacques Quételet by Joseph-Arnold Demannez
Lambert Adolphe Jacques Quételet is the man responsible for this contribution to society. Born in Belgium in 1796, it took him half of his life to develop this abomination. And it is our duty as growing people of science to debunk it. So, let’s do this one step at a time.
1) He’s A Statistician Using a Flawed Formula
You read that correctly. He’s not a physician.
Quetelet was interested in applying his knowledge to study how an average person grows and mapping it out using a mathematical formula. He found that the average weight was approximately estimated by taking any individual’s weight in kilograms and dividing that number by that individual’s height in square meters.
In many things, that kind of approximation might be good enough – particularly when you don’t have the means to get exact measurements. Engineers approximate all the time. But not like this. This is like trying to estimate how fast someone should be able to run by measuring the leg lengths of the overall population and dividing that by amount of time it takes them to make one stride. First, that’s not how you calculate speed, and, second, even if it was, that’s not going to tell you the speed of any individual person. Just like taking someone’s weight and dividing that by their height squared is not going to tell you what the weight of any individual person should be.
2) Satisfactory for Monoethnic Populations
The BMI runs into its second problem when you take into consideration the population that inspired its creation – the Belgians. In the 1830s, like today, they were composed of two types of people: the Flemish, Dutch-speaking Belgians, and the Walloons, French-speaking Belgians. However, the language they speak doesn’t distinguish their Germanic ancestry. They both had a similar diet and, naturally, their bodies adapted to it. Naturally, a study that approximates the average weight of individuals that are historically, dietarily the same is going to be consistent.
But what about countries like America and Canada? Or areas such as North Africa? Polyethnic nations cannot be assessed with an average. Unlike a nation with a majority coming of one common ancestor, these nations and regions have many, meaning different historical diets and different metabolisms. In these cases, an individual’s healthy weight, then, cannot be judged by the region that they reside in. What might have been considered a healthy weight in an individual’s ethnic origin cannot then be judged by the region based on an average of that region.
3) Skewed Average
You might have already put this together, but those abiding by the BMI that are polyethnic are heavily influenced by the ethnicities that are more numerable in number, as averages work. For example, if you wanted to take the average of 10 numbers, and 8 of those numbers are very low, then the average is also going to be low. So, in populations like America, which is a country with a majority of the people being of European descent, the BMI does not properly judge an individual that doesn’t fall into the same category.
4) Corrupt Motive
Why would health organizations worldwide accept this standard? Who does it benefit?
According to the National League of Cities, an organization devoted to fighting childhood obesity, we know that the obese accrue more healthcare cost in America – a fact that is universally sensible, even if the BMI didn’t exist. But if we deviate from a conversation on America’s inefficient healthcare system (and, believe me, it is incredibly ineffective), and look at the system in relation to the previous three points, we can take critical information. America uses this quick and easy system in order to give insurance companies, around which the healthcare system thrives, information on those that they insure.
Everyone wants to be healthy. A person that is told they’re obese, even though that weight may not be a determining factor in their longevity, will do what they can to reduce their weight and improve their lifestyle; the stigma of the word “obesity” is a powerful driving force. Insurance companies are aware of the rate of obese people in each state and, given their private business status, they can influence their prices according to this information. And they absolutely do.
Combining my second and third point shows that minority ethnicities within polyethnic nations lead to a misrepresentation about whether they are overweight or obese. Alas, this was proven in 2009 at The Endocrine Society’s 91st Annual Meeting.
The Impact of Pseudoscience
Inaccuracy, corruption and science do not mix. I begin the segment called “The Torrent” to call attention to the improper use of sciences on social life. As you can see, even your doctors, healthcare authorities, have been led to use this system. And even though they know of its flaws and actively fight against it by doing things such as recommending a waist circumference measurement as a tell to, the system still reigns.
The only way that we combat this intrusive worm is through this aggressive exposure of where it goes wrong.
On that note, let’s discuss. Please share to spread this conversation topic and join our mailing list for more.