I’ve never really taken a lot of notice of BMI calculations as I always thought it was another health indicator which should NOT be applied universally to all and was just a convenient short cut tool for lazy scientists and medics. I’ve noticed recently that there are more and more people questioning the application and it’s even starting to be a story line argued on certain medic shows.
So what’s the history and why and how did it become this myth an indicator of good health? Just like calorie counting is the myth of diets, cholesterol levels and salt the myths of heart health.
Adolf Quetelet, a Belgian Astronomer, mathematician, statistician and sociologist developed the algorithm in the 19C. It was never intended for medical application.
While Quetelet’s work was used to justify scientific racism for decades to come, he was clear about one aspect of the BMI: it was never intended as a measure of individual body fat, build, or health.
For its inventor, the BMI was a way of measuring populations, not individuals — and it was designed for the purposes of statistics, not individual health.
There are now many studies indicating the grevious flaws in applying it to the field of medicine - mostly indicated very simply in this article to which I would add one more - it’s shaming. So please - if your doctor uses BMI as an indicator - challenge, politely and offer evidence to the contrary, of course.
I just chose this article for the discussion as many find medical studies difficult to read and interpret but there are many such studies on medical sites for those that look.
Nutrition is far more important and lacking than simplistic, out dated, never should have been used in the first place, impersonal algorithms. So if you are otherwise active and feeling good but stressing about being achieving the ‘perfect’ BMI - please stop!
So, what do you think? Should we be questioning the use of outdated methodology?
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CDreamer
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Aha, had lengthy convo with my lady GP, my daughters age 😜 AND YES, she’s saying the same as me! 👏🏼 BUT she thinks it’ll be many years before we women get the treatments take lores for us 😱
And her sisters head of a Complementary Therapy association 😜👏🏼👏🏼
It's unbelievable that women are still treated like we are "second class citizens in this day and age. Whatever is wrong is all in our heads. 😡 I've read several articles lately about how Drs dismiss women's health. In young women too. It's called medical gaslighting. Have had it happen to me more than once. And god forbid you open your mouth to complain. You are then labeled hysterical or hostile or noncompliant. It's so frustrating. And seeing another Dr isn't much help when I can't afford better insurance. Feel like not going to the Dr anymore.
They wouldn’t dare with me.Last December had a right debacle with my femoral hernia. I should have been a very urgent 999, strangulation. Hours upon hours waiting, my husband was going to bundle me in the car for an 8 Mike journey up roads with works in them. Eventually got taken to major hospital in our area on morphine dumped in a&e for hours then left in emergency morphine wearing off. Treated like unwanted parcel. Consultant wanted to put PLASTIC mesh in, quicker. I refused point blank, look up Vaginal mesh!!
Oh yes that mesh is bad news. I remember listening to a nurse on TV here in the USA years ago who had it. The tissue in her vagina grew around it. She was in immense pain. Finally had surgery to remove it. It was so deeply imbeded in the tissue no way to remove it all. She was in pain all the time. Her husband sued for "loss of intimacy with his wife." Don't know what the outcome was for him. These pharma companies always have money to pay any lawsuits they might lose. They don't care. Had a friend who had Crohn's and had mesh in her intestines. Caused her pain and a Dr other than the one who originally put it in, operated on her. This Dr told her whoever put it in really did a bad job and that if she ever had to have more surgery and more intestine removed she'd end up with a colostomy. She got sick with it again back in 2016 and couldn't afford insurance then. By the time she found a Dr who would help her (after begging 7 others for help) it was too late. She died in the same hospital a couple weeks later that she had sought emergency care at a couple months before. They just gave her some antibiotics and sent her home. That's our wonderful medical system here in the USA. And yet these illegals are getting free care......
I had a gynae procedure recently ( hysteroscopy) performed by a man. It wasn’t a pleasant experience as he had to give me an anaesthetic half way through and ‘pull down’ my very far back tilted womb to take a biopsy….really painful, but that’s another story. The letter I received from him afterwards said that I was ‘anxious throughout the procedure’ 😳 well it’s not surprising is it, with cameras and injections, instruments and goodness knows what there…I’d like him to try it !🙄
She describes the pelvic as being totally inflamed with the tape doing no job at all.
We have brilliant young Dr Eva Fong in NZ. I should have had it done 2.5 years ago at ACC's expense. No they said 1mm from damage is NOT DAMAGE.
I said MONITOR I am now on anticoagulAnts.
Finally saw Dr Fong November - well its through now. 3D scan showed it all.
Any NZpersons with mesh complications should reply me. We have a lawyer waiting in wings too carry out a CLASS ACTION against JOHNSON & JOHNSON who are paying out compensation.
Because of ACC and not able to sue our NZ Surgeons we want to go beyond straight to Johanson & Johnson who lied to say it swas safe AND IT WAS NOT.
cheers J
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I would see it as one of several indicators of health/illhealth. My husband has slim arms and legs but used to have most of his weight distributed around his body, particularly his belly. He has had several very serious conditions at least partly related to lifestyle but in his case his waist size was a better indicator of problems to come. One of my daughters has a wide body with big bones and weight fairly evenly distributed, exercises regularly and eats a healthy basic diet albeit with some alcohol and cake added! So I was amazed to find her GP surgery has her rated as obese based on her BMI. I could go on but as with AF I agree you have to look at the bigger picture and consider genes as well. A previous GP I had asked me on my first appointment with him what illnesses were prevalent in my wider family, to which I replied ‘Ulcers on my mother’s side and AF and lung problems on my father’s’. I was very impressed by that approach and I think it would be worth our bearing it in mind even if our GPs don’t ask 🤔
Interesting question CD and not entirely off topic as we always quote the LEGACY trials here regarding obesity and AF. There is no doubt at all that obesity has a negative effect on lots of heath matters so we do need to have some kind of marker for it. Maybe you can come up with a new idea? All I know is that for me, dropping four on the scale moved me out of the pre diabetic range pretty quickly. As you say, we are all different.
What I would point out is that body mass in our population has risen dramatically since WWll or even the fifties. One only has to look at any family pictures to note that there were very few bulky people around compared with the average high street today. "Normal" has always been a moveable feast after all just as "facts" have a finite life.
There are lots of alternative indicators and when slides from the Legacy trial showed cutting down eating the quantity of fish fingers to one and half - I lost faith completely.
The point is that BMI was never intended as a medical marker and is shaming. Weight does matter of course but it’s the fat we carry and where it is that matters far more and there are SO many different reasons for how and where we carry fat, as indicated in the article, that using BMI as a marker is shaming to those who may never achieve the ‘perfect’ BMI and therefore counter productive.
Educating people to eat well is by far more a productive method, but first we need to educate our doctors .
Totally agree. When Sam stopped work and had time to cook rather than heat up meals our food bill dropped by 35%-40% and our health up by quite a lot. We eat very little processed foods these days. As I say regularly diets don't work but life style does.
To answer Laceylady's point there was adequate food unless you consider sweets essential. Nobody starved and we ate what was put in front of us. Fast food was fish and chips and we had salt with everything so not everything was better. Processed food was almost unknown unless you included Spam or corned beef. Mind you the only time we saw oranges was at Christmas. lol
I agree completely that we need to educate our doctors. The head of my surgery said to me that as a rule doctors are a conservative bunch and on average it takes approx 17 years for them to change. Nutrition is barely touched on in their road to becoming doctors and there is no doubt that we are what we eat. In my opinion much of today’s ‘obesity’ comes from people not getting the right nutrients and their bodies craving them. Our stone age bodies are programmed to like sugar and fat but much of that comes from ‘empty’ calories but they are addictive. Often thirst is mistaken for hunger. Many of today’s veg are grown in fields which no longer have the minerals etc which they used to have although they look great.Obesity does not take into account the body shape ie broad shoulders etc. Men and women’s bodies react differently and most trials have been conducted on men in the past.
I believe we need a varied diet with little or no processed foods. Sweets are a def no-no as is icecream etc (pity).
I eat a well balanced diet, but, have a rare fat disorder. And before any of you start to think, yes, ok, any excuse, take a look here Dercum’s.org
It’s a fat disorder, obesity is a major symptom plus lots of painful angiolipomas all over the body. No known cause so no real treatment. Only treating the symptoms, so surgically removing lumps when they become unbearable, otherwise pain control. So how can someone judge the likes of me by using the BMI?
That must be so difficult for you and exactly the sort of reason I posted. We can all be just too quick to judge when we use simplistic tools - which we’re never intended to be used as a medical assessment measure in the first place. Very shaming on so many levels and I was horrified to learn of the racist history associated with its’ intent. Time we left these in the history books.
I am a Scouser - the pan of scouse on the stove or scrag end hot pot bulked out with pearl barley in the straw crate prepared the night before so it was ready when everyone got home. I learned to plan ahead and make a meal out of anything in the larder, which often wan’t much, from an early age. It was good training.
It’s all be making a big return and as we head into economic crisis and when food becomes scarce and expensive, especially meat - we may all be a lot healthier.
BUT we need the skills and the commitment to do it and put the Pre-prepared food companies out of business.
I’m born Liverpudlian, Both mum and dad Liverpudlians and obviously lot of relli’s. Well I was born in Bootle, Thornton Rd house. Think mums family in Wavertree but can’t remember, they did move around a bit. Grans last home in Cranborne Rd. Forgotten the name of the Road Dads sister lived in at the moment,
Can’t say I agree with that Bob. I have a photo taken with the females of the family when I was a child. They were all « Lipton’s Orphans » a euphemism in their day for rather large!!
Ya, I was going to mention the old school/family/group pics.Also, even the military has changed. The fitness standards have dropped drastically over the decades as mechanized warfare has replaced walking and running great distances. Soldiers fly, ride and float into battle. Look at a troop/squadron group shot from 40 years ago, and one from 2020...a noticeable difference.
Yes BMI is misleading for many, but stats are stats, and we have been eating far too much, too often, too many processed foods, too many carbs and too many excuses. It’s crippling our healthcare system and we know it.
Yes, it is a shame that so many cannot afford healthy choices...especially in a world where fast food is cheaper than fruit and vegetables...but here we are in the 21st century.
There are overweight and underweight and bang on. You wouldn’t know by looking how fit each on is, how much exercise they can do, how furred up their arteries are! So that’s when tests, scans etc reveal deeper that shows thin can have fat round organs but not whole body, overweight don’t always have furred up arteries BUT the way I understand is, if you are for example 7 stones over weight (you are technically carrying a 7stone rucksack around all day) so if someone is slim at say 8 stone then ask them to pick up and carry that all day imagine the struggle on all body parts including heart ❤️. So they use the BMI as this sort of guide is the way I understand it - an no I’m not a skinny waif of ideal BMI - I carry my invisible twin round and wish I could put them down but my arteries are clear of plaques but AF stopped me exercising but I’m trying
Interesting, but I hope what doesn't get lost is that studies demonstrate that losing weight can significantly improve or even eliminate afib in many individuals.
Also health benefits with diabetes, blood pressure, cholesterol, etc.
So whether you want to measure being overweight by BMI, percent body fat, or weight tables, I think anyone who reasonable is categorized as overweight, especially with health issues, should consider losing weight as one of the first interventions.
That doesn't mean it's a one size fits all -- no pun here -- and as has been said, men, for example can be what is called "skinny fat" where they are thin except for around the abdomen which is suggestive of the metabolic syndrome.
Absolutely correct , for me to achieve the perfect BMI I'd have to lose 2 stone and I'd be skin and bone .I'm 5 ft 10 inches and weigh 13 and a half stone with a 34 inch waist .
My very much overweight nurse advised my BMI was 30 so I should consider losing weight 🤣
My husband's office organised years ago for a firm to come in and do fitnesss assessments on them. He ( well muscled playing squash 3 x a week) and the office marathon runner ( no fat on him at all !) were both deemed obese by BMI. The couch potatoes who had no muscle came out with desirable weight!
Definitely not controversial! Like many measures it had its uses and like many measures it's a blunt instrument. If you're looking guidelines as to dosage of drugs, and intravenous medications etc YES BMI is a useful measure even calculated with age. Unfortunately this simple measure has been conflated over and again with other stats e.g. people with BMI of X are more likely to get heart attacks/diabetes etc. But we don't necessarily have other data about those people's lifestyles and health conditions to say nothing of gender and ethnicity. I'm sure there are some fancy stats done around multiple conditions and how these correlate with BMI but, bottom line for me, we can't use BMI as a determinant of 'Good health'. Or well being.
I agree with most of what you say, and BMI has fallen out of favour more than once in my memory. In fact, until recently, when I'd seen it mentioned a few times, I thought it was no longer used scientifically and that doctors preferred measurements of specific fatty areas such as the upper midriff since this is more likely to be an indicator of excess fat around the major organs of the heart and liver.
As for education, well, over the years I have come to despair that it simply doesn't work or at least manages to preach only to the converted. How we get people to change their habits is far more difficult than simply "education" it seems.
BMI is not used by my doctor, nor any other doctors I’ve had in the past 20 years. The chart makes no sense at all. Like you said, it was not designed as a health indicator. According to the BMI scale, I am overweight. I am 6’ 1” @ 185lbs which puts me JUST under the “overweight” line. I wear 32/32 pants, flat belly, hike 3-4K with the dogs every morning, cycle 25-40k 4-5 times a week, do resistance training and light weights *grandkids ain’t getting lighter* ...and my doctor says “you are FIT!” ...but according to the BMI scale, I am “at risk”
It’s not an accurate measure for sure.
Questions you and your Doc should be asking...
How is your bloodwork?
How do you feel?
How is your diet?
How well do you sleep?
Do you have type 2 diabetes or other health issues, that your health care provider feels could be addressed by reducing visceral and body fat percentages?
Do not Google images of “ The perfect body” or stare in the mirror or hop on the scale and sigh every day...throw OUT your scale...it’s not needed. 🙂
I believe BMI to be a fairly accurate indicator, as losing 50 pounds and getting into a ‘normal’ range has improved many of my health issues. My husband has recently shifted into an ‘obese’ range, and his blood pressure, sugar, and joint conditions have all taken a problematic upsurge. We are working on bringing him back into a normal BMI. That is just my opinion, though. Following a Cardiac or Mediterranean diet has helped us. It has to be a lifestyle change, though. We are Americans, and portion control seems to be an issue with a lot of us.
A certain "dignified" and "sanctioned" quackery has always been present in medicine, and for that matter everything from exercise to types of food. Remember when back in the 1990's we were told to eat a high carb diet? Then they said THAT was all wrong, we should go all protein!! The so-called experts change their edicts from decade to decade. The BMI "law" has always seemed gimmicky to me.
My hospital appear to use BMI as some sort of indicator still. I had a gynae procedure recently done and the gynaecologist letter I received afterwards from the hospital wrote what my BMI was. I’m 5 ft 8 and 11st and it’s within the normal range, but I did wonder what difference it would have made if I wasn’t.
Every time I go to any appointment at my hospital, be it for my heart or anything, I’m weighed and my height is measured.
in inches sorry folks I believe it is 35-37" for woman
38-40" for men
when I was tld by the new doctor to stop eating meat and cheese because I was overweight I went home
measured my waist andI was 2"over!
When I saw this doctor again I said buy measure tapes fr al your patients. Get them to do a measure. It is a better challenge and they can tell whether they are overweight or not.
I've heard "my husband likes me this sway - cuddly!
or
I feel good - but displaying a right big BUM and wide hips.
I said to Dr I'm not deleting meat, my meat is 99% meat 1% fat.
My expensive cheese is 40% less fat and is organic.
I eat salmon 3-4 days weeks, pasta 1 day and meat or egg meal.
I have thyroid hormone synthetic pills every day which can make 1 fat but my weight stays about the same.
Look my Mum had big bones, so do I. I have problems losuing weight. Waking up hungry in the night is not my thing.
cheri. JOY
The nurse who talks cardiac is mAssively overweight and her comment is one of the above.
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