Home Health and Fitness The good, bad and ugly about BMI

The good, bad and ugly about BMI

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The term BMI is a dirty word for some people.

BMI stands for Body Mass Index and is just a rough measure of a person’s body fat based on height and weight. It was invented for use by researchers in large groups of people to see how weight affects the development of disease and chronic health conditions. In these studies, it is effective to classify a population of people into weight categories based on her BMI.

Studies show that elevated BMI increases the risk of chronic diseases such as heart disease, high blood pressure, high cholesterol, type 2 diabetes, respiratory disease, stroke, mental illness, sleep apnea, osteoarthritis and physical pain. is also known to rise. 13 types of canceraccording to U.S. Centers for Disease Control and Prevention.

But critics say the term BMI has become a social judgment that perpetuates misconceptions about weight by lumping individuals into arbitrary categories. even if everything Backlash against “fat shaming” Weight stigma against being severely overweight or obese persists, According to research.

“Our society and social media say, ‘You should be thinner, you should be thinner.’ If you’re not skinny, you’re not good enough.” You can’t be big, but you can be healthy and big,” said Joan Handelman, a registered nurse and clinical director of the National Eating Disorders Alliance.

“Putting the word ‘obesity’ in quotation marks is because I personally think it’s slanderous,” said Susan Bivert, an anti-weight discrimination advocate and Project Heal board member. Project HEAL is a non-profit advocacy organization dedicated to helping people with disabilities. messed up meal.

“But it’s completely medicalized that health equals weight, and weight equals health, based on BMI. It’s not true,” Bibert said.

BMI measurements can be completely wrong in some cases, said Thomas Waden, a professor of psychology at the University of Pennsylvania Perelman School of Medicine.

“Think of a young woman who is 5 feet 5 inches tall and weighs 150 pounds. rice field. Weight and Eating Disorder Center.

“But she can be incredibly muscular, and most of her weight can be in her lower body, which doesn’t hurt her health as much as her upper body weight,” he says. “She could easily say, ‘I’m perfectly healthy, so I hope she keeps her BMI at 25.'”

To calculate adult BMI and weight is divided by the square root of the person’s height. (For those with mathematical disabilities, the National Institutes of Health free calculator to work for you. )

Frazao Studio Latino/Getty Images

Critics say the term BMI perpetuates misconceptions about weight by classifying individuals into arbitrary categories.

As currently definedA BMI of 18.5 to 24.9 is healthy weight, 25 to 29.5 is overweight, 30 to 34.9 is obese, 35 to 39.5 is class 2 obese, and over 40 is “severe” or class 3 obese. called morbid obesity. If your BMI is less than 18.5, you are considered underweight.

Muscle and bone are heavier than fat, so BMI measurements can overestimate body fat in athletes and people with a muscular or large build. Conversely, it has been reported that BMI may underestimate body fat in older people and those who have lost muscle. Harvard TH Chang School of Public Health in Boston.

More conundrum: Women have more body fat and less muscle mass than men, while some racial and ethnic groups are genetically prone to have more or less lean muscle mass and body fat.

The use of BMI in children is also problematic, According to the CDC, Because a healthy weight range for a child is based on BMI from the 5th percentile to the 85th percentile. CDC growth graph.

“Because the interpretation of BMI is dependent on weight, height, age and gender, it is difficult to provide healthy weight ranges for children and teens,” said the CDC.

That’s why parents should never use an adult BMI calculator to determine a child’s weight status, the CDC said.

Still, the use of BMI in the clinic has a role, said Justin Ryder, M.D., associate professor of surgery and pediatrics at Northwestern University Feinberg School of Medicine in Chicago.

“We have good data to support chronic disease if you carry enough weight for a long period of time,” Ryder said. “It may not be in the form of high blood pressure or diabetes or heart disease. It may be musculoskeletal problems, depression or sleep problems that impair quality of life.”

Researchers have found that fat cells send out inflammatory signals to the surrounding tissue. The signal says:cytokine stormWith COVID-19, many people are in intensive care.

“Fat doesn’t just exist as a storage container,” Ryder says. “It’s an active endocrine tissue, so the longer you hold excess adiposity or fat, the longer it takes to excrete some of the inflammatory cytokines and other factors associated with chronic disease. ”

what should a person do? Ryder advised seeing a doctor who considers the patient as a whole.

“Physicians need to look at things in a bigger, broader picture,” he says. “They look at an adult patient and don’t just say, ‘OK, your BMI is 31 so you need to lose weight,’ and that’s not always the answer.”

If BMI is so troublesome, why don’t doctors use other measurement tools?

For example, waist circumference is another way to measure body fat, especially visceral or “hidden” fat, which is the most dangerous type of fat for your health.

This type of fat is hidden under your abs and cannot be pinched. Even skinny people can get this condition, but it’s called TOFI or ”.Thin on the outside, thick on the inside— Visceral fat usually increases with a bloated belly.

Visceral fat wraps around the liver, heart, kidneys, and intestines and excretes inflammatory proteins. increase the risk High cholesterol, heart disease, stroke, type 2 diabetes, insulin resistance, Alzheimer’s disease and other dementias.

“Men should have a waist circumference of less than 40 and women less than 35,” says Wadden. “Exceeding these numbers can lead to intra-abdominal fat in the upper body, which is more likely to be associated with health complications.”

Other measurement tools being considered in the medical field as an alternative to BMI include the waist-to-height ratio (WHtR) method, which is calculated by dividing waist circumference by height. Some researchers tout the tool as a good predictor of future cardiovascular health. Easy to use and not very age dependent, but according to the 2022 recommendations it should not be used by children under the age of 6. Literature review.

But Ryder says none of these alternatives appear to be viable solutions at this time.

“Other tools that can be used to measure body fat are impractical in a clinical sense,” he said. “From a research standpoint, these are great tools, but doing it in the clinic would just cost extra money for the patient. There is no such thing.”

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