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The Body Mass Index Grew out of White Supremacy, Eugenics and Anti-Blackness

Today, we treat “obesity” (measured as a body mass index [BMI] ≥ 30) with a surprising seriousness, given its history. Fear of fatness did not begin as a medical concern. In fact, it took off in the mid-18th century. At that time, several race scientists began arguing that being “too fat” was bad specifically because it had been linked to women of color. Renowned scientist Georges-Louis Leclerc, Comte de Buffon, for instance, repeated claims made by other scientists that Chinese people while not all “fat and bulky … consider being so as an ornament to the human figure.” Adding that one could find, therefore, many Chinese women with enormously “big bellies.” Big bellies were also, according to Buffon, a noticeable deficit among the women of some African tribes.1

These ideas crept into medicine through eugenics. Eugenics was a late-19th to mid-20th century movement to promote so-called better breeding by identifying qualities of the human race to be cultivated and defects of the human population to be eradicated through selective breeding. Race and weight were intrinsic to their concerns. In the United States, eugenicists like the zoologist Charles Davenport argued that fatness was a constitutional flaw. The “low” types betrayed this form of embodiment. Chinese and Jewish people, for instance, were thought to be prone to a lamentable “racial obesity.”2

Davenport and other eugenicists, by combining race science and medical science, were inventing what I call a “white bannerol of health and beauty.” This bannerol pseudoscientifically bundles attractiveness and healthfulness. Peoples and physical proportions that had been held in high or low esteem by race theorists and philosophers of beauty were, with the eugenics movement, subject to a new form of medical penalty. These faux-scientific notions about body size, health, and desirability (especially for women) would ultimately make their way into the medical mainstream.

Davenport had frontloaded race in his pseudoscientific understanding of the link between weight and health. He’d also embraced the latest science for identifying how much fat was believed to make a person sick. Such notions had arrived by way of the insurance companies.

The insurance industry had long been creating so-called “standard weight” tables. These tables gave the average weight by age and height for thousands of people judged by insurance companies’ medical examining boards to be sufficiently healthy to be acceptable life insurance risks.3 Most of the insured were white, but the insurance industry’s primary concern was not in identifying racial differences but in demonstrating a link between weight and health. This was the mechanism used to delimit potential policyholders and, by extension, potential monetary payouts. Yet the insurance industry’s ignoring race did not stop Davenport and others from continuing to make racialized assertions about body weight. Davenport was known to use the weight tables to advance his eugenic claims about a racial factor in obesity.4

Still, as the 20th century wore on, eugenic claims were becoming less tenable. The devastation of the Holocaust led some postwar scientists to publicly admit that race was not biological.5 During the 1940s and 1950s, the medical community downplayed the overt role of race in questions of health, even those about obesity.6 A new emphasis was placed on discipling the bodies of all people based on the insurance industry weight tables, which unfortunately still relied on an implied white standard.

Read entire article at AMA Journal of Ethics