Expert: Joanne - 9/23/2007

Question
I'm 5'9 and have a larger, denser bone structure than average. Right now I weigh 168 lbs and my ribs are showing. According to the BMI tables, 135 lbs to 169 lbs is the "healthy" weight range for my height. I'm also in WeightWatchers, and my goal weight with them is 140 lbs, but I'm wondering if sometimes the BMI tables can be wrong for some people--that is, I'm wondering if you can still be medically "underweight" even if you're BMI is in the "normal" range for your height.

And I'm struggling because right now I am very anorexic and I'm worried that my family and my treatment team are going to want to put me back in the hospital (I've been in Johns Hopkins Hospital's ED treatment program twice, when I was at higher weights than I am now) even if my BMI is still above 19 or 20.

Thanks.

Answer
Although a lot of units and Drs use BMI as a measurement - it is quite inaccurate for some people.

A body builder may have no fat on his/her body, but weigh a lot due to the sheer mass of muscle - they will have a high BMI even though they are not overweight unhealthily, and again this can be true when people have a heavier bone mass than the 'average' person.

I think Drs just have to take into consideration the build of people when judging whether or not they are overweight/underweight.

I think that you need to be honest with your family and treatment team - things will not improve while you continue to pretend that this is not happening.  You need their support.  I think that you need to be honest with your team, and speak to them about not wanting inpatient treatment again, and see if there is another program that they can recommend.

Please let me know how things go!

All the best
Holly