To think that BMI is largely a load of twaddle?

[dizietsma]

I think it's high time the medical establishment came up with a better way to monitor health, BMI is a misleading health index at best.

A while back I was talking to an Endocrinologist because I experienced a lot of hormonal disturbances after taking Depo Provera, and she mentioned that my BMI was high. I pointed out that I thought BMI is a very poor tool for understanding the health of an individual and several studies have elaborated on its inefficiecies. She agreed!

So why are we still using this flawed measurement?

"Illustrated BMI Categories" Set of Pics

"Please note that I'm only defending the blasted BMI because of the anti-science undertones in a couple of posts."

There's nothing anti-science about insisting on accurate health measurements that people so people can make informed health decisions. Quite the opposite!

But Dizietsma - no, you're not isolated from the media but you don't base decisions on what you read in the latest Heat issue either. You may find you use epidemiological studies showing e.g. that overweight people have a poorer health outcome than others. I'm not saying doctors aren't prejudiced but I think for work purposes they'll stick to science.

"'well have you always been naturally skinny'. I said yes and she shrugged and said 'well honestly, don't let it bother you. The BMI isn't that accurate."

This is good healthcare! This is what I'm talking about!

Everyones health is an unique situation that simply cannot be boiled down to BMI, yet it has become a standard of healthcare in this country.

You are a bit barking, Dizietsma. So you think all this healthy eating malarky is just a huge conspiracy?

Show me the studies (not a command, but would make for a good discussion) showing what you want them to show. I leave it as fuzzy as that because you are still not clear what it is you want.

SenseofTouch - anorexia has 4 criteria which are typically used, one of them BMI 17.5 or less. It's a criterion. Same as amenorrhoea. If you're on the Pill you may not know if you have missed 6 cycles or more. It's a criterion. Intervention is not decided on this alone.

I take the point it's not a very good measure. But I disagree that BMI is used in such a powerful way in decision making.

"But Dizietsma - no, you're not isolated from the media but you don't base decisions on what you read in the latest Heat issue either. You may find you use epidemiological studies showing e.g. that overweight people have a poorer health outcome than others. I'm not saying doctors aren't prejudiced but I think for work purposes they'll stick to science."

Of course no (good) doctor will make decisions based on influence from the media. But they DO live in a society that ever increasingly values the super skinny far more than the normal/larger. I think it is impossible to disentangle these influences, unless you are aware enough of societal influences on your outlook to monitor them. I've met very few doctors with that sort of self-awareness.

Dizietsma - I agree that it is good healthcare because rather than making me stress about a problem that wasn't there, she actually put my mind at rest and understood that my body wasn't going to conform to some chart!

I actually have another relative (non-blood) who it looks like will have similar problems to me. She is a teenager and is involved in performing arts and because anything performing artsy needs to be seen to be doing the right thing in terms of weight and health nowadays, she has been told that if she doesn't put on weight by the time she gets to sixth form, they may not be able to take her back. Totally ridiculous in my opinion. I understand them having to be careful but this is a girl who does not have a problem with eating and is going to struggle with putting on weight because it is not the way her body is designed. It makes me angry that she is feeling pressure to change her body weight even though she is perfectly healthy, but to conform to some politically correct picture!

BMI is just pounds per foot with 25 pounds per foot being "normal".

I don't think it should be used solely as a medical decision.

"You are a bit barking, Dizietsma. So you think all this healthy eating malarky is just a huge conspiracy?"

Erm... where did I say anything that implied that I thought there was a conspiracy? Big fan of eating healthily, actually. Just not a big fan of health measurements that are inaccurate.

"Show me the studies (not a command, but would make for a good discussion) showing what you want them to show."

Wiki article on the limits and shortcomings of BMI

It's kg per metres squared. So e.g. I'm 67kg and 1.70m tall, gives me BMI 67/(1.7*1.7)=23, within the normal range. If I put on 10 pounds or so it would take me in the overweight range. I have weighed much more than this, I felt healthy at the time but I am glad I've got rid of the excess as it makes running after the children easier.

Cthea...actually it often is. A friend of mine has had an eating disorder of the same severity for about 15 years, but only now has she fallen into the anorexic BMI, and only now is she getting offered proper help. If the BMI and amenhorrhoea were taken out of the equation people may get the eating disorder treatment they need before they have damaged their bodies to the point of no return.
Another friend of mine has recently found out she has become infertile, due to having had an eating disorder for years, however she has only been able to recieve out patient care for a few months. This was not based solely on BMI, but it played a significant role in the allocation of an OP place for her.

dizietsma - apologies, my misunedrstanding of your previous post, you did in fact say weight was not as importand as healthy eating and exercise. And I found the link interesting read and agree with it, just don't think the other measurements are quite ready yet or easy to use. I know in the elderly you can use a demiquet where you measure from middle of the chest to base of middle finger instead of height because they may have shrunk with age and BMI may not be all that good a measurement.

SenseofTouch - that's very sad to hear that tickboxing takes precedence over clinical judgement.

"you did in fact say weight was not as importand as healthy eating and exercise."

I think you are confusing me with someone else, whilst I agree with the sentiment, I did not actually post that!

Oh God, apologies to Dittany then as well. Not doing very well, am I?

One of the things that bugs me is that my hospital notes BMI at the antenatal booking in appointment at about 10-12 weeks. Online it says that BMI norms shouldn't be applied to pregnant and breastfeeding women.

Having measured this, it is a significant factor in making decisions which may have a significant impact on a woman's care during pregnancy and birth.

I find it disturbing that so many of the general population seem to equate BMI with bodyfat, which is absolute rubbish. When I was teaching nutrition, I used to include this in the multi-choice questions and it was horrifying to note that over 40% of the students would say that yes, BMI was a measure of body fat.

My BMI is and always has been in normal range, but I know for a fact that my bodyfat at the moment is way higher than it should be (having far more now than I did when I was last measured with calipers). My physiology lecturer colleague always said that the only truly accurate measure of bodyfat was rendering, but it's not a particularly useful pre-mortem way of sorting it out. He loathed the over-use and over-emphasis on BMI.

So OP: no, YANBU. It should not be given the emphasis it is.

A pound of muscle weighs the same as a pound of fat; shock horror. Muscle is DENSER than fat, hence the difference.

Oh and internal body fat (for people who are slim and may not actually realise) is a lot worse than external fat that you can see. Fat surrounding your organs isn't good.

BMI is one of the measurements use to check an individuals health and should be used in conjunction with their Waist circumference measurement to determine health risk. BMI is used to compare weight with height and estimates whether the individuals weight is healthy or not. BMI does not measure % body fat. Waist circumference measures central abdominal fat and in looked conjunction with an individual's BMI will indicate whether they are at no risk, high risk or v high risk for developing diabetes, heart disease or hypertension. For example for a woman if your BMI is 27 (overweight) but your waist circumference is 30 inches( normal range) then you will be in the low risk category but if your waist circumference was 35 inches then with the same BMI you would be in the high risk category and with a waist circumference over 35 inches your risk would be very high.

gpnotebook.co.uk/simplepage.cfm?ID=1584070728
This is the link if you want more info about looking at BMI with waist circumference to assess risk of developing health problems.
*just to correct a mistake in my 1st message I meant no increased risk rather than no risk.

also to add that the normal waist circumference measurements for people of south asian descent ( includes people from the indian subcontinent , Chinese, Japanese) is different from that of Caucasians and black people. For people of south asian descent normal range for women is 31 inches and under and for men its 35inches and under.

Isn't that because on average they are actually shorter and therefore in proportion to this?

BMI is like everything else - it has limited use. But the fact is that someone who has a BMI of 37 is highly likely to need to lose some weight.

The problem I have with it is that I don't understand why the range is the same for men and women when men have a higher proportion of muscle.

I think it is fine as a rough guide as to whether you are overweight or not.