Author Topic: Body Mass Index and Obesity  (Read 20412 times)

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Re: Body Mass Index and Obesity
« Reply #30 on: September 15, 2010, 12:58:25 PM »

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From our friends at Wikipedia:

While the formula previously called the Quetelet Index for BMI dates to the 19th century, the new term "body mass index" for the ratio and its popularity date to a paper published in the July edition of 1972 in the Journal of Chronic Diseases by Ancel Keys, which found the BMI to be the best proxy for body fat percentage among ratios of weight and height;[3][4] the interest in measuring body fat being due to obesity becoming a discernible issue in prosperous Western societies. BMI was explicitly cited by Keys as being appropriate for population studies, and inappropriate for individual diagnosis. Nevertheless, due to its simplicity, it came to be widely used for individual diagnosis, despite its inappropriateness.

Lazy doctors spewing the company line, IMO...allows them to quickly cover their asses and say they counseled patients on weight.  Yes, with a bp of 110/65, good heart rate, and solid lab results, I was still called obese by a doctor that barely looked at me.  Just lazy...

I'm of average height at 5/10 (with killer post moves, btw, so don't underestimate...), but here's the math problem that you taller fellas might be running into with the BMI, again from Wiki:

For a given height, BMI is proportional to weight. However, for a given weight, BMI is inversely proportional to the square of the height. So, if all body dimensions double, and weight scales naturally with the cube of the height, then BMI doubles instead of remaining the same. This results in taller people having a reported BMI that is uncharacteristically high compared to their actual body fat levels.


Re: Body Mass Index and Obesity
« Reply #31 on: September 15, 2010, 01:09:30 PM »

Offline Fan from VT

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ehh, it's not a conspiracy. It's also not perfect by any means. It's like any broad population based statistical measure: may not apply to all individuals but is a strong risk indicator for most people.

It's basically telling you, based on your height/weight ratio, what the risk is of developing cardiovascular disease, specifically type 2 diabetes and heart diseases. That's it. In general, those with BMI's greater than 30 are at noticeably and significantly greater risk of developing type 2 diabetes and heart diseases.

Of course there are many complicating factors:

1. Our general idea of "physically fit" really may not have ANY connection with "Health," at least as measured by what the BMI recommendations are based upon (heart disease, diabetes, life expectancy). It's really a socially determined idea that is located in a specific cultural time and place and is now connected to things like huge muscle mass and achievement in certain athletic events. However, to my knowledge, there have been no studies that have tried to link that type of physical fitness to the outcomes linked to BMI, namely life expectancy, heart disease, and diabetes. Because there have been no studies, it may be the case (not saying it is, but i'm saying we can't be certain that it is not) that someone we see as incredibly "healthy" (physically fit), such as, say, a strong running back like Adrian Peterson, may, due to his high body weight, be putting a strain on his heart that will shorten his lifespan, despite being a modern day paragon of strength and fitness. I don't know. But I know that we can't mix our social ideas of "healthy" (i.e. i see healthy with my eyes and know what it is) with measured outcomes, if that is how you are measuring health (which is further debatable and ties to quality of life/goals of life). Statistically, body weight is extremely tightly correlated with developing heart disease, decreased life expectancy; the general correlation is so strong it's almost inarguable at this point.

2. Obviously, though, when using such a broad statistical tool, there are major exceptions, and clearly it will not be true for all people. That's why, when used correctly, the BMI is simply one of many many tools for determining overall health.


Here is what one BMI website said:
Quote
Risk Factors:
High blood pressure (hypertension)
High LDL cholesterol ("bad" cholesterol)
Low HDL cholesterol ("good" cholesterol)
High triglycerides
High blood glucose (sugar)
Family history of premature heart disease
Physical inactivity
Cigarette smoking

For people who are considered obese (BMI greater than or equal to 30) or those who are overweight (BMI of 25 to 29.9) and have two or more risk factors, it is recommended that you lose weight. Even a small weight loss (between 5 and 10 percent of your current weight) will help lower your risk of developing diseases associated with obesity. People who are overweight, do not have a high waist measurement, and have fewer than two risk factors may need to prevent further weight gain rather than lose weight.


Someone can have perfect BMI, but eat crap, smoke, drink, and have a genetic predisposition and be at HUGE risk for heart disease. Furthermore, as the above says, you may be overweight but have no family history, not smoke, etc, and you're probably at neutral risk.

Additionally, there are "cardioprotective" factors, aka "negative risks." These basically, in statistical terms, "cancel out" one positive risk or counteract a few pounds of weight. Such things include:
Small Waist
High HDL cholesterol
Heart Healthy foods
Regular Aerobic exercise



3. And, of course, there's huge individual variation. we all know and tell stories of ridiculously healthy people that just die, and of ridiculously unhealthy people that live a long time. Of course, psychologically, we remember those and use those as evidence for why the BMI is evil, and tend to push aside the far more numerous instances of people dying at 62 with heart disease. Confirmation bias/shock bias.

4. Outside circumstances are HUGE and clearly are not measured by the BMI. Couple examples:
-If someone has a history of anorexia, and is now slightly overweight, you'd better recognize that being slightly overweight is far healthier both physically (despite what media says) and mentally than being anorexic. Absolutely stress how healthy they now are.
-If someone has a mental illness and is on medication, some medications can cause serious weight gain (from 5-10 lbs for some antidepressants to rapid gains of 40+ pounds for some of the stronger ones). Obviously you want to be extremely careful in finding a balance here to find the best overall health for the person in question, factoring in quality of life, emotional balance/satisfaction, physical health, self harm from their illness, etc.



To conclude my thoughts on the BMI:

-The BMI alone can in no way tell you if you are "healthy."

-The BMI is one tool to help paint a picture of overall health RISKS. It is a strong tool, stronger than many want to believe, but it NEEDS other tools. Otherwise it's like trying to build a house with a really nice hammer and that's it. Not going to work.

Re: Body Mass Index and Obesity
« Reply #32 on: September 15, 2010, 01:25:32 PM »

Offline nickagneta

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Regarding using BMI as a tool to measure risks against decreased life expectancy let me just say I care for my 98 year old grandmother who is physically fit internally but has such severe dementia she doesn't know who I am anymore and is starting to forget how to feed herself.

Increased life expectancy is severely over rated given the quality of life that can occur and care that this country provides for it's elders.

I'ld rather live a good life and die in my late 60's to early 70's. Unfortunately, barring accidental death, that isn't going to happen because genetically my family tend to live into their 90's.

Re: Body Mass Index and Obesity
« Reply #33 on: September 15, 2010, 07:06:26 PM »

Offline dark_lord

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it said im in the normal range (woohoo ;)).

it might be a flawed tool in some ways, but its also a good indicator to work with.  i think theres a ton of overweight/obese people in our country and is an epidemic, especially in children.  i think its easier to dismiss the tool as being out of date or inaccurate, rather than come to the realization one is overweight.  it is easier to make excuses than it is to make a change.

personally, i think people need to watch what they eat, exercise, and maintain a healthy weight. im in good shape and people sometimes actually rib me about it, as if thats a bad thing.  they are quick to say i have a fast metabolism, but in my 30s, my metabolism is not fast. i dont like how people equate my weight to metabolism because i work really hard at not indulging in unhealthy foods, exercise regularly even on days im tired and unmotivated, and am invested in maintaining a healthy weight. i dont let other's judgment impact me tho.

my decision to maintain a healthy weight stems from having a child, so i would like to try to do all i can to maintain solid health.  i also do martial arts, so a healthy weight really makes a difference in how my body handles the punishment, my agility and flexibility, and my ability to perfom.

but thats just me and my opinion.  to each their own

Re: Body Mass Index and Obesity
« Reply #34 on: September 15, 2010, 08:18:14 PM »

Offline screwedupmaniac

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Did John Hollinger make this system?
TP...an almost post of the year worthy comment. ROFL

Haha, thank you kindly! Nothing like a little humor to help the offseason roll along smoothly. John Hollinger's PER system is still much more of a joke than this obesity scale nonsense is...and that's saying something.

Re: Body Mass Index and Obesity
« Reply #35 on: September 15, 2010, 08:35:19 PM »

Offline birdwatcher

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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.

Body mass IS a crock. Ideally if your insurance covers it, you may want to get a body composition test, which basically weighs you in water. The end result is an itemized breakdown of your weight by body fat, lean mass, skeletal structure and all your other blood and guts.

Another way is to buy yourself a cheap pair of body fat calipers, which along with a few simple measurements and a handy chart can give you a good idea of how much subcutaneous fat you have. It suffers from the same problem as BMI calculators in that it can't account for bone structure or the fat around your internal organs, but it can better illustrate what type of weight loss/fitness goals you should attain.

Before my final comment, I will say that I myself was once 5'7" and 205lbs. The last year and a half I have worked out regularly at the gym, switching out routines every 3 months but keeping with a simple workout structure--full body exercises, with weekly variations of the 6 basic movements (deadlift, squat, bench press, rows, pull ups, dips) only 3-4 days a week. Mixing in kettlebells or intervals on the stationary bike and increasing my protein intake and switching from white starches and sugars to whole grains (swap wheat for white breads, sugar in the raw for white table sugar) and I now weigh 172lbs and am currently at 10% body fat. At 35 years old, I am about to have a 6 pack for the first time in 18 years (have to drop 3 more % pts for that).

My final comment is--it's great that you walk that much, but unless you figure out your target heart rate and keep it in that zone for a minimum of 25 minutes, it may not be enough. 245lb at 5'11" is pretty heavy, even if when you look in the mirror you carry it well. It took me a looong time to really "see" myself. For instance, for years my waistline was bigger than my inseam (36" waist, 30" inseam). The day I decided to take my weight seriously, my pants ripped when I bent down. I cut one of my pant legs off and cut open my waist line and laid them side by side. To see my waist a half a foot longer than the length of my leg was startling! So, with all due respect, don't  be pi$$ed off at the BMI calculator for showing you something you may have already known. You can fix it--you may just need an eye-opening experience like I did to realize you need to adjust your effort.

I sincerely hope I didn't offend you, I shared this with the best of intentions! If you need any advice or ideas, I would be glad to help.

Re: Body Mass Index and Obesity
« Reply #36 on: September 15, 2010, 09:29:06 PM »

Offline nickagneta

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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.

Body mass IS a crock. Ideally if your insurance covers it, you may want to get a body composition test, which basically weighs you in water. The end result is an itemized breakdown of your weight by body fat, lean mass, skeletal structure and all your other blood and guts.

Another way is to buy yourself a cheap pair of body fat calipers, which along with a few simple measurements and a handy chart can give you a good idea of how much subcutaneous fat you have. It suffers from the same problem as BMI calculators in that it can't account for bone structure or the fat around your internal organs, but it can better illustrate what type of weight loss/fitness goals you should attain.

Before my final comment, I will say that I myself was once 5'7" and 205lbs. The last year and a half I have worked out regularly at the gym, switching out routines every 3 months but keeping with a simple workout structure--full body exercises, with weekly variations of the 6 basic movements (deadlift, squat, bench press, rows, pull ups, dips) only 3-4 days a week. Mixing in kettlebells or intervals on the stationary bike and increasing my protein intake and switching from white starches and sugars to whole grains (swap wheat for white breads, sugar in the raw for white table sugar) and I now weigh 172lbs and am currently at 10% body fat. At 35 years old, I am about to have a 6 pack for the first time in 18 years (have to drop 3 more % pts for that).

My final comment is--it's great that you walk that much, but unless you figure out your target heart rate and keep it in that zone for a minimum of 25 minutes, it may not be enough. 245lb at 5'11" is pretty heavy, even if when you look in the mirror you carry it well. It took me a looong time to really "see" myself. For instance, for years my waistline was bigger than my inseam (36" waist, 30" inseam). The day I decided to take my weight seriously, my pants ripped when I bent down. I cut one of my pant legs off and cut open my waist line and laid them side by side. To see my waist a half a foot longer than the length of my leg was startling! So, with all due respect, don't  be pi$$ed off at the BMI calculator for showing you something you may have already known. You can fix it--you may just need an eye-opening experience like I did to realize you need to adjust your effort.

I sincerely hope I didn't offend you, I shared this with the best of intentions! If you need any advice or ideas, I would be glad to help.
No disrespect felt or feelings hurt, it's just you guys don't know my situation or even what I look like.

When I left college I was in the best shape of my life at 22 years old and 205 pounds. I had a 48" chest and 32" waist with 32" inseam and my guess is I was under 10% body fat as I was cut.

Now 23 years later I weight 40 pounds more. I have a 54" chest and 38" waist and of course same inseam. But here's the thing. I don't have time in the day to exercise so I do it walking my dogs in the morning. 1 1/2 hour to 2 hour walk, anywhere from 5-7 miles. I have to walk them every day(Boxers are one of the most energetic and athletic breeds of dogs and have to have the exercise) so that's my exercise.

I am also physically limited as I have severe lung issues(asthma and sarcoidosis) so can't run and had most of my L5 and S1 vertebrae removed when they collapsed during an accident. So heavy lifting, twists at the waist and other such limitations occur there. Both my neurologist and orthopedic doctors recommend walking or swimming as the best exercise for me.

I love swimming but have to walk my dogs anyway so I walk because I don't have another 1-2 hours in my day to go to the Y and swim. I also run my own business, have three kids and am the sole care provider for a 98 year old grandmother and just re-entered college to go back and get further degrees and change my career path.

Also, I take two prescriptions who's side effects cause high cholesterol and weight gain. When I started taking them I weighed very consistently for 10 years between 220 and 225. Within 9 months I had put on 20 pounds. That was 6 years ago. My psychiatrist thinks it unlikely I will be able to return to that weight as long as I am taking the medication at the dosage levels I take them but given I like the stability they provide, it's a trade off I am more than willing to take.
 
So suffice to say, I'm very busy, have no time for exercise, have little in the way of vices except Celticsblog and the good dinner I cook every night and am unlikely to loose a lot of weight due to medications.

So, am I overweight? Yeah, I admitted as such but I know I am not obese and I am happy with the way things are.

But the BMI thing is still a crock and a horrible tool to gauge individual obesity.

Re: Body Mass Index and Obesity
« Reply #37 on: September 15, 2010, 09:45:03 PM »

Offline birdwatcher

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Man that's rough. I'm willing to bet that one of those meds you take is for depression, as I'm a little sad for you myself for the fact that your life is 99% occupied. The business (as a former restaurant owner, I get it) can be a huge burden at times, the kids, taking care of your family, then having to come home and burn off a couple hours of pent up pooch energy...[dang], I'm tired!

BMI=BS for sure. I'm far from an elite athlete, but my bmi says I am in the obese range too, that I am 29 lbs overweight. Also, it's not just the system that's flawed with BMI, it's the scale (no pun intended) that they use. They say a 30 yr old man who is my height 5'7" ideal body weight is 150lbs. Seriously? I'd look like a malnourished street urchin if I was that weight!

I'm sure you weren't looking for advice with this post, but keep walking the dogs and keep working hard. Anything you do is better than nothing at all, and you don't have to diet, just alter your diet from time to time. A simple thing like eating less red meat over the course of a week (it can take weeks to digest and can basically compact in your settle in your bowels--the average person carries up to 18lbs of compact waste in their colon!) or not eating anything white (rice, bread, flour, sugar) for a few days at a time can really make a difference, especially once you see your body respond to what you are doing. Drink 3-4 qts of water a day and it might just surprise you.

With that, I promise to never speak of this again! Good luck and take care of yourself.  ;)

Re: Body Mass Index and Obesity
« Reply #38 on: September 15, 2010, 09:47:16 PM »

Offline crownsy

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Didn't qoute cause the I phone sucks at it but I looked at the chart and I read the
Low end of obese for 6'1 as the full range.

But still, 180 being obese for certain 6'1 guys seems absurd. I guess I
Could get down to 180, but I wouldn't really feel healthy about it. 140 is ridiculous with my body frame.

I think the main problem is it doesn't take anything other than weight into account. I have plenty of tall thin friends who could pull off 150 at 6'1

But I also have plenty of athletic friends like myself who couldn't do that at all, at least not without dropping a ton of muscle along with fat
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Re: Body Mass Index and Obesity
« Reply #39 on: September 15, 2010, 10:02:14 PM »

Offline JSD

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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 sure this has been said, but BMI is 100% pure garbage. According to this tool, clean bodybuilders are considered morbidly obese and unhealthy. It's crazy...

Next time you're at your doctors office, ask him to take your body fat % and then research where you should be for your height and weight. That's a much better way of determining your overall health.

Re: Body Mass Index and Obesity
« Reply #40 on: September 15, 2010, 10:03:45 PM »

Offline Redz

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So, am I overweight? Yeah, I admitted as such but I know I am not obese and I am happy with the way things are.

Then nothing else matters.  If you're happy with the state of your body and you're clearly capable of rational though, than who cares what anyone else thinks?
Yup

Re: Body Mass Index and Obesity
« Reply #41 on: September 15, 2010, 10:08:51 PM »

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BMI was explicitly cited by Keys as being appropriate for population studies, and inappropriate for individual diagnosis.

This is a good point - the BMI isn't necessarily a bad measure; it's lousy for individual cases but is probably a solid measure of large groups.  State-by-state or nation-by-nation BMI can tell you something; individual BMI tells you very little.

Re: Body Mass Index and Obesity
« Reply #42 on: September 15, 2010, 10:22:22 PM »

Offline nickagneta

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Quote
So, am I overweight? Yeah, I admitted as such but I know I am not obese and I am happy with the way things are.

Then nothing else matters.  If you're happy with the state of your body and you're clearly capable of rational though, than who cares what anyone else thinks?
Exactly my philosophy. Who cares what people think who aren't important to me and when it comes to my body even the important people opinions aren't exceedingly important.

You have to feel comfortable in your own skin, as my grandfather used to say.

But what got me going was the fact that the doctor was using such a flawed tool. Clearly, I believe I am an example of why the tool is flawed. I am confident in myself so no harm done.

But what about those impressionable teenagers, especially girls, who's self confidence is fragile? What about those like jasail's wife who have eating disorders in their history? What about the millions of weight conscious women who aren't anywhere near overweight or obese but are being told they are and suddenly are traumatized and start spending big bucks on diets and stuff.

That's what my beef is, not that he called me obese or what others are saying about my weight.

Re: Body Mass Index and Obesity
« Reply #43 on: September 15, 2010, 11:55:24 PM »

Offline guava_wrench

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There is too much going on for us to control for weight when trying to figure out ideals.

Looking at hunting and gathering groups, which is what our species was for most of our history, they look pretty lean. It may be that our body evolved to have maximum life expectancy at a much leaner body size than we consider decent looking at present. On the other hand, we evolved in ways that allowed our ancestors genes to be passed on, not in ways that would make our life enjoyable or worth living. We also likely did not evolve such that we would be healthy long past our fertile years when we no longer need to nurse.

Studies seem to show that extreme caloric restriction actually extends life expectancy, but that the restrictions are so extreme that is greatly decreases the quality of living.

My point is that there needs to be a trade-off between longevity and what will make your life livable based on your personality, including what you enjoy. This trade-off needs to take into account long-term effects, since most of us would rather make some sacrifices now than go through dialysis as a result of really bad diabetes.

Re: Body Mass Index and Obesity
« Reply #44 on: September 15, 2010, 11:56:40 PM »

Offline indeedproceed

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There is too much going on for us to control for weight when trying to figure out ideals.

Looking at hunting and gathering groups, which is what our species was for most of our history, they look pretty lean. It may be that our body evolved to have maximum life expectancy at a much leaner body size than we consider decent looking at present. On the other hand, we evolved in ways that allowed our ancestors genes to be passed on, not in ways that would make our life enjoyable or worth living. We also likely did not evolve such that we would be healthy long past our fertile years when we no longer need to nurse.

Studies seem to show that extreme caloric restriction actually extends life expectancy, but that the restrictions are so extreme that is greatly decreases the quality of living.

My point is that there needs to be a trade-off between longevity and what will make your life livable based on your personality, including what you enjoy. This trade-off needs to take into account long-term effects, since most of us would rather make some sacrifices now than go through dialysis as a result of really bad diabetes.

Both scientific and philosophical. Nice.

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