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

laza222 - have had the same problem. I LOVE my midwife who out right refuses to weigh me or note my BMI (in defiance of some of the other staff I have had to see) because she knows I am just little.

Dittany you are right up to a point, but it is true that EXCESS visceral fat, which may not be visible as external fatness, is more dangerous to health.

The reason why there is a current "obsession" with body weight is because so many people are far too fat. The small number of excessively skinny supermodel types is obviously concerning, as is the link to anorexia and body image problems and dysmorphias. However this is a much smaller problem than the ever increasing proportion of people who are overweight, and the health problems associated with that. BMI is simply a screening tool. It should be used only as part of a range of indicators in risk assessment. I am sure that there are those who use it in a heavy handed way, or who do not understand that is it pretty crude. But it is very simple, requires no special equipment and can be done with little or no special training. Also the range of normal is very wide (I could weigh between 9 stone 6, and 12 stone 6 and still be in the normal range). When I was superfit I gained a stone, and lost two inches around my waist. I was still in the middle of the range (and very obviously healthy). When dh was bodybuilding he moved into the obese range, but this level of fitness is very unusual, and professional athletes do not use BMI in any case, as they have coaches and specialists to monitor their every step (and it is debatable whether they are in fact healthy in any case).

The other thing to note is that as we have collectively got heavier people have got much worse at identifying whether or not they (or their children) are at a healthy weight or not.

Bear in mind that doctors see a disproportionate number of over weight people because of the associated health issues and you may understand why they are so aware of the issue. When we took our children for their annual health check in the States (it is a requirement for all children, and we lived there for six months) the doctor was in positive raptures that neither of them was overweight. It was very odd, but when we went to the local swimming pool we could understand why.

YABU, BMI is a good tool to use for the average person on the street, especially if the person isn't trained to measure body fat correctly with callipers.
The BMI is not a good tool for professional atheletes but most of the people on the street aren't professional atheletes. It also shouldn't be used for pregnant women.
As JodieO has pointed out muscle is denser than fat.

Doctors read BOTH Heat and the BMJ rather than Heat and Lancet.

brettgirl2 - they are different graphs for men and women.

"BMI is simply a screening tool. It should be used only as part of a range of indicators in risk assessment."

Well that would be awesome, but my experience is that it is not used as part of a range.

Whilst pregnant my MW's did every test under the sun to prove that my pregnancy was being negatively affected by my BMI, none of them came up positive which obviously pissed them off, so they just used BMI to harass me instead.

I could not understand why they couldn't just be pleased that all was going well, but it really seemed to annoy them that they couldn't say, "Look, you've got gestational diabetes, that's what happens when you're a fatty.", or "Look, your blood pressure is too high, that's what happens to pregnant fatties.", or as they latterly tried to fearmonger me "Look, our highly inaccurate 3rd trimester screenings are showing that your baby is a fatty too, that's because you're a big fatty and now your birth will be really hard." My exactly 50th weight centile newborn DD also proved them wrong!

Why can't healthcare professionals accept that it's actually possible to have a relatively healthy body and not conform to BMI standards?

Possibly because being over weight is a risk factor for some serious health risks during pregnancy. So they are duty bound to follow those up. Of course risk factors are based on population epidemiology which means that depending on the numbers more or less individuals will be affected. You obviously fell into the unaffected group, but if you hadn't would you not have been grateful for the extra care?

Of course if they were unpleasant about it, that's another matter.

I guess I see it like smoking, not all smokers will die from it, indeed some will live long lives, but enough won't for the huge push to try and get them to give up to be justified. In the same way being very fat has negative impacts, as an individual you may choose to ignore or to carry those risks, but don't be surprised when those who have seen those risks be realized put pressure on you to reduce the risk.

Of course if they do that badly it is totally counter productive, but there we go, unfortunately no one has discovered the effective nag so far.