LettersIn Hong Kong’s weight management plan, BMI should be one data point among many
Readers discuss the new Action Plan on Weight Management, a university’s commitment to humanities education, and how Hong Kong should respond to the latest Middle East conflict
BMI has significant limitations. Developed using data from white males, it doesn’t account for muscle mass, bone density or the beautiful diversity of body compositions across ethnicities. This is particularly relevant in our multicultural city. The government’s press release cites the recommendation of the World Health Organization Western Pacific Region for Asian adults but there are regional variations within Asia. If we apply a standardised BMI threshold to all, we risk misreading these natural variations in genetic lineages and body types as problems to be fixed.
The American Medical Association now advises using BMI as just one tool among many, alongside measures like waist circumference and genetic or metabolic factors.
This matters deeply for our ageing population. With dementia now the seventh leading cause of death in the world, research – including a 2024 BMJ Open study – warns that low BMI in Chinese older adults is linked to higher cognitive impairment risk. A 2022 study in Nature Aging found that being mildly obese was actually associated with lower mortality in Chinese adults over 80. Our public health strategy must be nuanced enough to ensure we don’t encourage our elderly towards a state that could compromise their long-term health.
We must also consider mental health. Hong Kong already faces significant challenges amid perfectionism and pressure. When a government initiative stresses “weight monitoring”, it can unintentionally validate diet culture – the belief system that equates thinness with worth. Many young people turn to controlling their bodies as a coping mechanism under stress. We must be careful not to tie self-worth to a number on a chart.