If by "grotesque" you mean severely underweight and anorexic            Yes, that's what i meant.     Extremely  few people are like that.         On the other hand,  of  the grotesquely, morbidly obese  i see quite a few   each time whenever i go to town  (beach, you name it).     And  i don't even live in the USA.         The thing about the BMI  is that there's a narrow and finite range between the normal,  healthy median (the optimum)  and  the minimum value required for survival (i've no idea what the minimum value is, around 13 - 14 perhaps?)  That's about 6 units max, with a generous allowance.       Whereas on the other side of the median (optimum),  practically the sky is the limit before you drop dead. Much wider margin there.                 This whole "anorexia" bogeyman is pure smokescreen bullshit.   Yes,  anorexics  exist (and they need all the help available),  but there are extremely few of them.          It's an unfortunate mental illness, not a lifestyle choice.    Feeling hungry (experiencing food withdrawal) at times is a mild inconvenience at most,  not starvation.