If BMI is so outdated what should be used instead?

[AutisticLegoLover]

Inspired by another thread where some posters are slating BMI as outdated.
BMI is a blunt tool, I agree, but what should be used instead? The old height weight charts were devised by American insurance companies or so I read in an eating disorders book. BMI was devised by analysing white European men. It's not possible to have everyone measured by callipers so what should be used? I personally think BMI is very generous and has a large range of healthy weight for height. 18.5-24.9 has a range of something like 3.5 stone for me but as a guide it's useful and ideally should be used alongside blood pressure and cholesterol and waist measurement. Not everyone can access BP and cholesterol checks easily though.
I am a retired GP Practice nurse and we used BMI but also had a height and weight chart on the wall. The height and weight charts are less generous. Still, it's just a blunt tool, a guide, an easy starting point.

What should be used instead to be more accurate for the whole adult population?

What is the thread where they said this @AutisticLegoLover ? I hear a lot of people criticise BMI, but I'm never really sure why. Obviously if you're a body builder things ar3 different, but most people aren't.

It's a blunt tool because it fails to pick up that in some populations (eg Chinese/some south east Asian ethnicities) a top end of "normal" BMI would actually be unhealthy and conversely might miss that someone with a genetically heavier build was actually dangerously thin for their frame.

I'm saying this as someone who is Obese at a size 14 and from the size of my hips and wrists should be targeting a chunk below the "normal" threshold.

Ok I have big boobs but the 28 inch back implies a smaller frame (should probably be a 26 back when a healthy weight for my frame.

@ScottishBeth this one:

What weight am I (with picture)? http://www.mumsnet.com/Talk/weightlosss_chat/4815674-what-weight-am-i-with-picture

I agree it is a tool that can be applied to many people. Being extremely short I feel the top end of BMI is too heavy for me.

I adhere to the late Terry Wogan's Fight the Flab message:

'Take off all your clothes, jump up and down in front of the mirror. Anything that's wobbling that shouldn't be wobbling, there's your problem.'

😬

while on BMI i'm definitely overweight, my waist measurement is only 1" too big as most weight is on hips and bum waist is relatively narrow as trousers that fit on hips are at least 4" too big at waist, so it calculates my risk of premature mortality as very low however my normal weight DH is only low as his waist is 35
BMI is a good guideline for most but weight in middle around organs is worse for you than weight on hips thighs and bum

Waist to hip ratio?

Varies trust to trust.

Some do 30 (beginning of obese) and some 25 (beginning of overweight).

Thing is, I personally know women who are horribly unwell and with a 'healthy' BMI and others who are incredibly fit and active but due to pcos won't qualify for IVF due to weight.

Thanks @AutisticLegoLover some of that thread is a bit insane!

Pleasingly I did the other calculator and my risk of premature mortality was very low. I'm losing a lot of weight at the moment but even before I did my risk of type 2 diabetes (from the Diabetes UK website) was low, which I was relieved about.

It's obviously a blunt tool and doesn't give any indication of other health factors / overall health, but as regards fatness I think it is pretty accurate.

I knew I was overweight before I found and did the calculator, and having lost 3 stone and now in the middle of the 'healthy weight' band I can see and feel that I am a much more healthy weight for my height and build.

And because I am an adult with a reasonable education and common sense I know that I should also eat a healthy balanced diet, and pay attention to other aspects of my health and wellbeing.

How could there be the Perfect Indicator accessible to all? We are not machines to be fixed and serviced by a team of external mechanics, we need to take responsibility for our own bodies and health - including asking for medical, therapeutic or social support when / if that is needed. e.g For eating patterns / disorders, food issues.

Yes, but amongst posters on that thread there is discussion about being in denial, being complimentary rather than blunt etc.
I'm not judging, other people's weight is not my business, just being factual.

Agree with majority here in that BMI is a good indicator for the vast majority of people.

I personally think the only time it’s less so is for avid gym goers with a lot of muscle. My BMI is 21 so ‘slim’ but I know a few people who lift weights who are 10-15kg heavier than me but look more toned and wear the same clothes size despite the fact their BMI would potentially classify them as overweight.

I'd like MN posters insisting their rather high BMI is very healthy "because BMI is rubbish" and "I look gaunt if my BMI goes below 25" to confess what their waist:height or waist-hip ratios are.

No one has ever called me gaunt. It sounds like some sort of badge of honour.

BMI is good for most people. It's not perfect but it is fit for purpose.

Have you looked at any of the research on this? Or does it just fit in better with your world view to suspect?

"They" (who?) are making changes to how BMI is calculated.
Have a look at theNHS page:
www.nhs.uk/live-well/healthy-weight/bmi-calculator/

I think BMI works for most people. I'm 5'10 with a 29 inch waist and am currently classed as overweight bmi. I lift weights but still think it's a good indicator as I do have fat to lose. Most people that dislike BMI would probably also dislike waist measurements. It's a good general indicator and there'll always be outliers, no matter the indicator

I think the waist measurement is a good one, it's less unhealthy to carry weight on your thighs than stomach

Well I am certainly overweight, there's no doubt about that. But I have a waist to hip ratio of 0.75:1, and my risk on the bsi calculator above comes out as "very low risk". I'm also really pretty active, and cycle, walk, swim, lift weights and play badminton (but have a good covering of fat over a decent chunk of muscle). When my BMI was 25 I definitely looked pretty slim (though not gaunt).

I have no idea if I'm healthy, I suspect the answer is no, but I also suspect I'm a hell of a lot healthier than friends a similar weight who don't keep themselves active.

The trouble with the calculator is that is doesn't take body frame into account. Many years ago I had an eating disorder, but at 5ft 2in size 5-6 feet and 8 stone it said I was well withing healthy limits. I actually looked very skeletal and had all my bones poking out....

My dh is one of those people that BMI technically doesn’t work for.

Ex international athlete, he has arms like pop eye, stomach muscles Houdini would be proud of and leg muscles that are actually bordering on grotesque if I’m honest.

When we were first together he had a BMI of about 22 or 23 which sounds very average but he was actually very very skinny. His ribs were actually sharp in places. A more “real” BMI for him would probably be about 20 or 21.

These days he has a bit of middle age spread and a BMI of 25ish. He isn’t overweight from looking at him. But he isn’t thin either. He is probably very average if you ignore the ridiculous muscles.

So I’d say that his level of muscle probably pushes his BMI up by about 2. But that is a result of years of international level training and - even now in his mid 40s - he still does 1 - 2 hours of very high level intensity exercise pretty much every day.

It isn’t something that happens because you go to the gym once or twice a week.

It’s fine! The range is wide to accommodate different builds. Everyone can fit in somewhere, with the exception of pro athletes (and I don’t mean people who go to the gym twice a week but think they’re Serena Williams!!)

It is a blunt tool and can be useful but it doen't tell the whole story. If you took 100 women with a BMI of 29, some would be far healthier than others depending on all the other factors that influence health. So while they might all benefit from losing weight, for some the extra weight has far more negative effects than it does for others.

So one person with a BMI of 29 who also has diabetes, hypertension, and a bad knee is going to be more impacted by the extra weight than someone with a BMI of 29 who is very healthy and active with no known issues.

Bargellobitch · Yesterday 13:19
MrsSkylerWhite · Yesterday 10:49

Hmm. Suspect people who are saying it’s outdated just don’t like what it’s telling them.

“Have you looked at any of the research on this? Or does it just fit in better with your world view to suspect?”

My “world view”? 😁

Nope, just several large friends/relatives who are clearly in denial. Size16/18 seems to be the average, certainly where we are (NW) and it lulls people into thinking they’re a perfectly normal size so are shocked when they’re told they’re overweight or obese.

I've always thought BMI is the same as height-weight charts but just a different way of arriving at the figure and the figures arrived at night hive a different range. It's the same in that it provides a rigid range between which it's said you're healthy and outside of which you're said to be at greater risk.
It's obviously a blunt tool but could be useful. Same for height-weight charts. Whether the particular ranges used are valid ones is another matter. Most individuals are entirely dependent on whoever produces them for that.