At ICED 2026, Dr. Rebecca Peebles participated in the panel discussion, “From Recognition to Action: Addressing Weight Stigma in Family-Based Treatment.” Apparently, during her part of the presentation, Dr. Peebles utilized this slide:

Dr. Cheri Levinson provided additional information about this slide when she posted on social media, “People with a BMI of 25-37 actually have the LOWEST mortality rates. Oh what?! Being fat is actually “healthy.”

This is where credibility disappears and the argument goes from substance to hyperbole.

It is widely accepted that BMI is not the best indicator of health. But, the conference slide did not merely criticize BMI. That would be easy enough to defend. BMI is crude. BMI is less useful at the individual level for people who are unusually short, tall, muscular, older, or racially and ethnically unlike the populations from which many cutoffs were derived. In 2023, the AMA said that BMI should not be used alone and should be considered with other measures, including visceral fat, body composition, waist circumference, and genetic or metabolic factors.

But that is not the same claim as saying that people with a BMI from 25 to 37 have the lowest mortality. That claim does something different. It takes a legitimate criticism of BMI and uses it to smuggle in a materially broader proposition that the evidence does not support.

The CDC’s recognized adult BMI categories are straightforward:

healthy weight, 18.5 to less than 25;

overweight, 25 to less than 30;

class 1 obesity, 30 to less than 35;

class 2 obesity, 35 to less than 40;

class 3 obesity, 40 or higher.

A BMI range of 25–37 is a rhetorically constructed category, not a medically coherent one. It fuses the categories, “overweight,” all of class 1 obesity, and the lower half of class 2 obesity, then stops before the evidence becomes harder to spin.

That is why the numbers are misleading. It is not a neutral scientific category. It is an advocacy category.

Flegal et al. 2013 did find that the standard overweight category, BMI 25 to less than 30, had lower all-cause mortality than the normal BMI reference group, with a summary hazard ratio of 0.94. But the same paper found that obesity overall, BMI 30 and above, had higher mortality, with a hazard ratio of 1.18, and that BMI 35 and above had an even higher hazard ratio of 1.29. So Flegal cannot honestly be used to say that 25 to 37 is the lowest mortality range.

The more recent U.S. NHIS analysis is also narrower than the slide’s implication. That study, using 1999 to 2018 NHIS data linked to the National Death Index, found adjusted hazard ratios of 0.95 for BMI 25.0 to 27.4 and 0.93 for BMI 27.5 to 29.9 compared with BMI 22.5 to 24.9. But the same article concluded that mortality risk was elevated by 21% to 108% among participants with BMI 30 or greater, while noting important age differences.

That is the evidentiary problem. The slide and argument appear to rely on the most favorable interpretation of the overweight literature, then extends it into obesity ranges where the supporting evidence weakens and reverses.

Unquestionably, the rhetorical sequence is efficient. First, attack BMI as imperfect. Second, invoke the 1998 cutoff change to make BMI categories look arbitrary. Third, cite Flegal for the proposition that “overweight” people had lower mortality. Fourth, visually expand the favorable zone on a graph until it appears to cover a much wider range. The audience receives one simplified message: higher weight is not associated with worse health and conventional BMI categories are suspect.

But each step requires a correction.

The 1998 NIH/NHLBI guideline did classify BMI 25 to 29.9 as overweight and BMI 30 or greater as obese, and it treated adults with BMI 25 or greater as at risk for associated morbidities including hypertension, high cholesterol, type 2 diabetes, and coronary heart disease. Before that transition, U.S. reporting had used higher sex-specific overweight thresholds, including BMI 27.8 for men and 27.3 for women. That history may show that BMI categories are policy judgments layered on epidemiology. It does not prove that BMI 37 is part of a lowest mortality range.

Further, the Flegal study is a mortality study, not a comprehensive health study. It examined all-cause mortality, not diabetes incidence, cardiovascular disease, sleep apnea, mobility limitation, fertility complications, liver disease, medication burden, surgical risk, or quality of life. Mortality is a blunt endpoint. A person can be alive and still have those health issues. Converting “not dead during the study window” into “healthy” is not epidemiology. It is overreach.

Nor does “BMI is imperfect” mean “BMI is useless.” The CDC says BMI is a screening measure that should be considered with other factors when assessing health. The AMA took essentially the same position: BMI has limits, but it can be helpful in certain scenarios when its benefits and limits are understood.

That is the honest conclusion. BMI alone is inadequate. But a nonstandard 25 to 37 range is worse. BMI is at least a disclosed measurement. 25 to 37 is a constructed talking point. A serious health assessment does not replace BMI with ideology. It replaces BMI alone with clinically meaningful data.

The eating disorder community deserves facts, evidence, scientific and medically based knowledge. Not empty rhetoric and not manipulated numbers to support a false narrative.

Families suffering from eating disorders deserve the unvarnished truth. Those families, those who live with, suffer from and sometimes, have to endure the unthinkable are why this community exists.

Manipulation of research and statistics to support a false narrative should not be tolerated. The community deserves better. Families deserve better.