Am I My BMI?

 

The BMI gets under my skin.

I have a love/hate relationship with the BMI. Is “hate” too strong a word? There is no love. At every meeting with my oncologist, the notice flashes on the screen – “You’re still overweight, Bozo!” 

So I do seriously dislike the BMI because I’m never in the good zone. I diet, exercise, skimp, and have said “no” to dessert so often that I feel guilty whenever I actually eat one.

Why do I even care if my weight is in the BMI (Blubber-Muscle Index) range that doctors say is healthy? I haven’t been in the healthy range since before cancer treatments began. And because I love a physical challenge, like hiking in Yosemite to the top of Clouds Rest at 10,000 feet, my inability to reach a good BMI frustrates me.

In the totality of cancer treatments and indicators, the BMI might be a minor detail, but it bugs me because it seems like it’s something I should be able to control. 

Every doctor’s visit begins with standing on the scale, and every time I am overweight. This is not a positive way to start an appointment. I might be okay if they weighed me naked, but haven’t encouraged this after that one time.

When I complain about the BMI, my oncologist says it’s just a tool they use, an indicator like the CBC, CMP, and PSA blood tests. He thinks I’m fine where I am, in the lower regions of being overweight. “Overweight” – now that’s a loaded term. 

He tosses in that overweight people don’t do as well with cancer therapies. This reinserts the burr under the worry pad in my head that a lower weight would help me get rid of cancer, and I feel a renewed pressure to conform.

There’s not a lot that I control with cancer. The doctors do most of the work, but I’m responsible for getting my sleep, exercising, and eating nutritiously. 

Genetics also play a role in determining what a healthy weight is for each person. We do have different body types. You can be fit and deemed overweight on the chart. You could have a lot of muscle on your body, which weighs a ton, and your BMI will be high. You can also never exercise and most of your weight is fat, yet be in the healthy weight range. So, by itself, the BMI is a relative number. 

Measuring the amount of body fat might be a better number to use, and I think you have to be submerged in water to figure this out, especially if you’ve had hormone therapy that changes your muscles into fat and dumps this around your middle, which means that calipers and tape measures around the waist, alternate methods of determining body fat, don’t work.

When I started treatments for cancer, knowing that the hormone drug was going to convert my body into a vertical pillar of fat and bones, I reduced my intake of carbs and gave up sugar, wine, and beer because I was told they either encouraged cancer to grow or they supercharged the side effects of the drugs. I don’t miss the drinking, but now and then an almond bearclaw is really important to my mental health.

How much of the food that brings me joy am I willing to give up forever in order to have a healthy BMI? Food has been a refuge for me, as it probably is for you. Beyond the nutrition it provides, food is enjoyable, and I turn towards it whenever I want to celebrate something. Food is a big motivator. It can make a hard treatment day bearable because it gives me something to look forward to – like a bowl of ice cream with chocolate sauce poured over.

The anti-androgen hormone drug I took for over a year messed up my metabolic system and put twenty pounds of weight around my middle. I’m still trying to work that off. Belly fat is really hard to lose. You probably know this.

I eat a fairly healthy diet – lean meat protein, yogurt, tofu, two vegetables for dinner, a variety of fruit. But I do like treats now and then. Snacking on vegetables doesn’t put a smile on my face. There are healthy foods I like that put on weight like peanut butter, avocadoes, and low-fat cheese. What complicates matters is that the cancer treatments left me with gluten sensitivity, so I can’t eat normal bread or healthy snacks made with wheat, which further restricts my options.

What I want to do is get my weight into the healthy zone and patch together a diet I like that keeps me there. Then I want to find out how many snacks I can sneak in without rising out of the zone. I would like to have dessert now and then. But if I can’t stay in the zone without any snacks, is that going to drain an important source of enjoyment out of my life? 

First I have to get my weight down into the acceptable range to see what I’m dealing with, and so far I haven’t been able to. I’ve shed most of the twenty pounds of cancer weight I gained, and I figure I have five more pounds to go before I finally enter the promised land with a BMI under 25.

Curiously, Silver Sneakers suggested this week that older adults might actually do better in the lower regions of being overweight with a BMI between 25 and 27 because this would foster better bone strength and cognitive health.

Maybe I need to relax. Perhaps where I’m going to be healthy and happy is slightly above the ideal BMI line. If I feel energetic, fit, and if all of my blood tests categories are good, then maybe this is where I should aim to be.

How I feel about my body because of cancer has also changed. I’ll talk about this is another post.

© 2026 Mark Liebenow