Body size measurements in public health: A social justice & weight stigma perspective

INTRODUCTION: The measurement and quantification of bodies and body size is a key component of many public health surveillance efforts related to obesity, disease prevention, and other size-related morbidities such as eating disorders or body image concerns. However, current body size measures such as Body Mass Index (BMI) or body silhouette measures used in Silhouette Matching Tests (SMT) have been widely critiqued as both stigmatizing of larger bodies as well as inaccurate. APPROACH: The main goals of this presentation are to further conversation about social-justice-oriented means of documenting body diversity, to critically discuss how these measures are used, and potential next steps for body size measurement. Body size measurement within public health will also be placed in context of recent research on the relationship between weight stigma, including healthcare-based weight stigma, and negative health outcomes. RESULTS: Utilization of digital technologies such as avatar development or digital portraiture may be a means of improving body size measurement in multiple public health contexts. Digital avatars could be both useful and enjoyable for participants, as well as a means of visual representation that includes different shapes and sizes, ethnicities and gender presentations. DISCUSSION: New flexible digital measures can both inform public health practice without being tied to stigmatizing claims, as well as offer a means of measuring and documenting the myriad ways healthy and unhealthy humans vary by size and shape.