Body Mass Index and Obesity

[indeedproceed]

I went to the doctor's yesterday for my annual physical and had an interesting discussion with my doctor. I was weighed in and I weighed 247 pounds at a height of 5'11" and age of 45 years old. near the end of the physical he tells me my cholesterol is high and I should start doing some exercise because my body mass index says I am squarely in the middle of the obese category.

I laughed at him. He asked why I was laughing. I told him, doc, I walk a minimum of 5 miles a day and in doing so usually am walking about a 16-17 minute mile with hills. There are days I walk 8 miles. I told him I know I need to lose some weight but even if I were to drop 20 pounds I would still be considered obese with that BMI calculator he was using.

I then asked him to go back and check what my BMI would have been at 18 years old when I was a Division III level athlete in baseball and football. He did. I weighed 190 pounds and my BMI would have put me at "overweight" then and with a BMI around 27.

What a crock!! I probably didn't have an ounce of fat on me then. I could run the 40 in 4.6 and bench my own weight easily several times minimum.

If this tool, which I see around the internet at weight loss sites all the time and is being used by the medical industry as well as the for profit weight loss industry, is telling our wives, daughters, kids and ourselves that we are obese, then it needs a serious retooling. Not every person fits into this BMI tool and for those with a larger frame and heavy muscular-skeletal makeup, such as athlete and such, it is just plain off.

http://www.halls.md/body-mass-index/av.htm

Here's a link to a site with one of these tools. You tell me. Enter your data and see where you come out. I found out that for me to be squarely in the middle of the healthy range I would need to lose 100 pounds. I haven't weighed 150 pounds since my freshman year of high school and would be well on my way to dying if I even attempted to get under 170 pounds, never mind down to 150.

I'm 6'4, and it says my ideal weight is 252 lbs.

I think that's about right. I weighed 220 once when I was 21 and I was unbelievably thin. I hated it (ladies didn't though so, I managed).

[35Lewis]

I just had this argument with my sons doctor about 3 months ago.  I have two boys who are 6 and 4 and she started telling me they were overweight due to BMI.  My boys don't have any fat on them and my youngest you can see ribs and abs.  Obviously I disagreed with her and told her it wasn't taking into consideration muscle mass but then I started thinking, even if it does take muscle mass it is just a stupid percentage driven index.  It seems to have become much more popular over the last 20 years.

[fairweatherfan]

If i lost an additional 80 pounds, i'd be emancipated.

I thought that hasn't been an issue since the 1860s. 

[jasail]

Funny this is a topic on here today, I just had a conversation with my fiance about this last night.  She had her physical and was in a tizzy about the BMI.  

She used to have an eating disorder as a teenager and is always worried about trigger; she is active and eats healthy but always tries to maintain a balance to not spark a poor self-image. With that in mind her physician told her, her BMI was good but she was on the high end of the normal range and should keep that in mind as she got closer to 30 and her metabolism slowed.  

Now she is 5'1 - 115, practices yoga, runs and weight-trains 3 days a week. Could she loose 3 pounds, maybe, but that would be asking her to maintain a Hollywood-esque figure.

So I come home last night and she is beside herself about having to loose weight to stay healthy.  So I ask her what she means and she tells me about the BMI.  

I stay on top of health and exercise as a hobby, which I am considering turning into a profession. So I explain to her that it is a rule of thumb that is by no means an indicator that should be taken seriously.  

I went on and told her 3 years ago I went to my life-long physician, he took my BMI and I was a 28.2 (5'10 195).  He started laughing and told me that my BMI put me close to obese. He told me I had put of 4 pounds since the year before but to disregard it.  

Last year I moved and went to a new Doctor, he took my BMI and I was a 26 (having lost a couple pounds from 2 years before due to increased training).  He sat me down and explained to me the dangers of being in your mid-twenties and overweight: Type II diabetes, heart disease, pulmanary embolisms, ect.  I sat and listened to him in absolute disbelief.  

He stops and I tell him BMI is a terrible indicator of health for active, muscular individuals. I tell him I eat 5 small meals a day filled with lean protien and raw vegetables; run, bike and swim more than 50mi per week, weight train, practice yoga and hike; and I recently had my body fat % taken and I came in a hair over 15%, putting me in the middle of the high fitness category.  

So after hearing me out I asked him why they used it.  From what I could discern he had no logical rationale for using this tool, besides it CAN give you a snap shot into whether weight may be a concern for the patient.  Personally, I think your eyes can do the same.  

With the relative ease of conducting a body fat % test or even doing simple measurements for the approximate algorithim I just can't understand why it is not more common.  It is far more accurate in terms of gauging risk for weight related issues.

Beyond all that what type of Dr tells a 5'1 115 lb petite girl with a medical history of eating disorders (which is in her record b/c she was hospitalized for it) that she needs to worry about her weight because she could get fat in her 30's.  I was in shock.  

[GreenFaith1819]

Wow -

First of all, TP to you, Nick.

I was weighed last week at the clinic and I'm 205 pounds, at 75 inches tall (6'2"). I plugged in my data and according to the link that you provided, I am overweight?

The one thing my doc told me a few years ago is that I must watch my cholesterol, but other than that I've checked out fine in my physicals.

This BMI is certainly interesting..

[screwedupmaniac]

Did John Hollinger make this system?

[guava_wrench]

I agree as well.

I'm 6'1 and lately i've been trying to lose some weight just to feel healthier.

I'm now down to 220 from 235, and the BMI scale still says i'm way towards the high end of obese.

now, I'll abmit i have a bit of a beer belly, which is why im trying to lose the weight, but i was looking at my "target weight" the other day and it says it should be 140-160 pounds.

If i lost an additional 80 pounds, i'd be emancipated. I'm a big guy in general, and an active athlete. I played MLB in HS, and at that time i was 225 pounds, and could move pretty quick and had pretty good stamina.

It really doesn't take into account body type. Some people, as you said through skeletal or muscle build up, are just not going to weigh 140-160 pounds at 6'1.

Are those the actual numbers, or did you misread a chart? They seem pretty off from what others have posted.

[housecall]

Ive ck'd those type guides out before and i figured they must be the Ethiopian Guide to weight loss.

[fairweatherfan]

I agree as well.

I'm 6'1 and lately i've been trying to lose some weight just to feel healthier.

I'm now down to 220 from 235, and the BMI scale still says i'm way towards the high end of obese.

now, I'll abmit i have a bit of a beer belly, which is why im trying to lose the weight, but i was looking at my "target weight" the other day and it says it should be 140-160 pounds.

If i lost an additional 80 pounds, i'd be emancipated. I'm a big guy in general, and an active athlete. I played MLB in HS, and at that time i was 225 pounds, and could move pretty quick and had pretty good stamina.

It really doesn't take into account body type. Some people, as you said through skeletal or muscle build up, are just not going to weigh 140-160 pounds at 6'1.

Are those the actual numbers, or did you misread a chart? They seem pretty off from what others have posted.

I thought so too so I looked it up - the normal range for a 6'1" guy is 140-189, which is much more reasonable, although I still don't know who's gonna be 140 at 6'1".

[guava_wrench]

Did John Hollinger make this system?

TP

[nickagneta]

Did John Hollinger make this system?

TP...an almost post of the year worthy comment. ROFL

[nickagneta]

here's the thing that gets me about the whole thing. The doctor just checked me out. I'm sitting there in my underwear. He can see I don't have a bit of fat in my arms or legs. I have a 54" chest a 38" waist a blood pressure of 110 over 70 and a heart rate of 69. Except for some fat(and not overly much) in the belly and chest, he can physically SEE I'm not anywhere close to obese and yet he's sitting there telling me I have to lose weight because I'm obese.

Like jasail's wife(TP BTW jasail, you tell your wife she's gorgeous just the way she is and then tell her something I'll say later), I am POSITIVE her doctor could look at her and see she wasn't anywhere close to being on the high side of normal size-wise and should have just kept his or her mouth shut. I mean, these doctors can't after a thorough physical LOOK at you after poking around everywhere and SEE you aren't overweight or obese?

But here's the thing. This formula was designed by a scientist in the mid 19th century and became popular and accepted in the medical field in the early 1970's before fast food, weight lifting, nutritional supplements, cable television, video gaming systems, home computers, and exercise became a staple of modern life in the world.

Now ask yourself this question, who is selling this formula to doctors? It's the medical software companies, medical equipment companies, and pharmaceutical companies. And why are they doing it?(Listen up jasail and tell your wife this)

Because they WANT doctors telling you you have a weight problem so they can sell you their stuff. It's because they want money and if you think you have to lose weight it is in their best interest long term. Check out who these companies are and what they manufacture and sell in their sister companies. It's unreal. If you think you're fat you are eventually going to be doing something that will make them money somewhere.

[fairweatherfan]

No offense though Nick, but if you're 5'11" and 247, you are substantially overweight, regardless of whether the BMI is a crappy measure (it is).  You might be fairly healthy now but that extra weight is very likely to cause health problems in the future, many of which will ironically make it much harder to lose the extra weight.  The high cholesterol just compounds this.

Don't miss the forest for the trees my friend, your doctor is basically right, even if he's using a lousy metric.

[TBreezy]

BMI as a guideline is not bad.  It is a simple cacluation that leaves a number of things out of the euqation - notably bone mass/density and muscle mass - everything is considered equal.

The better measure of fitness and shape is the body fat percentage - but that is more complicated than the simple BMI.

I don't know the intent on the BMI - but I imagine that it has somehting to do with limiting heart issues.  I wonder if excess muscle mass is bad for the heart?  The bigger the body the more work it has to do right?  Perhaps the BMI is justified in its ratings - but perhaps the names of the ratings are not the best?  I don't know.

But body fat percentage is the best indicator of body consititution.

[nickagneta]

No offense though Nick, but if you're 5'11" and 247, you are substantially overweight, regardless of whether the BMI is a crappy measure (it is).  You might be fairly healthy now but that extra weight is very likely to cause health problems in the future, many of which will ironically make it much harder to lose the extra weight.  The high cholesterol just compounds this.

Don't miss the forest for the trees my friend, your doctor is basically right, even if he's using a lousy metric.

No offense fwf, but you are substantially wrong.

Overweight I am. Substantially, I am not. With my muscle structure and skeletal structure if I got much under 220 pounds my guess is my body fat % would be around 15-18% or so which is real good for a man my age and weight and height.

Take a look at NFL safeties who are 5'10" to 6'0" and weigh between 200 and 220 pounds. They are unbelievably fit and yet the BMI would say they are heavily overweight to obese.

BTW, my cholesterol is high because I take a medication called seroquel who's main side effect is increased cholesterol. So it's a health risk I take physically to remain stable mentally and emotionally.