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MY BMI Controversy

I posted the original blog (following this blog) in several weight-loss groups. In short order, someone told me that I was way off in my thought process and that I ignored the well-documented issues regarding the ethnic disparities. She was right.

So, still in my state of hubris, albeit somewhat lessened, I thought I could address her concerns in a re-write, and my position would still hold. It doesn’t. While researching this blog, I found an excellent article in the medical journal Circulation that discusses this exact issue in detail. So, after reading the article and some deep thinking on my part about what I believe and what is societal conditioning, here is the new blog.

The BMI Scale is a simplistic equation using weight and height. (Multiply your weight in pounds by 703; then divide that number by your height in inches, squared.) It is easy for researchers to calculate and use to making broad statements about weight and obesity for large populations. It becomes problematic when you start to apply it to individuals. What the BMI calculation fails to do is take into consideration several additional known factors, including age, sex, genetics, ethnicity/race, and activity level affect a person’s body fat distribution and composition.

Additionally, researchers and clinicians find that many patients may fall into the overweight and obese levels, but are metabolically healthy. And conversely, some patients are in the normal range and metabolically unhealthy. Metabolic health is based on your blood tests, A1C, cholesterol, liver enzymes, etc.

The primary reason for labeling people healthy, overweight, and obese is to help predict probable diseases in patients. Using BMI as fat an initial screening tool is a good start, it is not sufficient. There are several additional clinical tools that doctors should use, including waist circumference (WC), MRI, CAT scan to measure visceral fat (fat stored in the abdomen), and liver fat. Both visceral and liver fat are key predictors of co-occurring disorders like diabetes, heart disease, and liver disease. To properly use the combination of BMI and WC, there will need to be more research to develop proper age-, sex-, and race/ethnicity-specific waist circumference guidelines. However, MRI and CAT scans can be used to visually assess the visceral fat mass.

So, what do I NOW think about BMI? BMI is a piece of the puzzle. It should not be used as a diagnostic tool. It is one of many to allow doctors to have accurate discussions with their patients regarding potential health risks. And currently, the tools to have the proper conversation are incomplete. The BMI calculation should not be used by individuals, health/PE coaches, or trainers to determine what you should weigh.

Additionally, I am changing my weight-related goal to be less specific. I may lose 170 pounds or I may lose less. The scale number is far less significant than how I feel and how I can negotiate the world. And my metabolic numbers are very important. What is most important is I love my body right now. So, wherever my weight stabilizes, I will still love my body and I will be happy.

Wishing you good health! And remember, be kind–especially to yourself.

LLC & Hazel

ORIGINAL POST

So many people will tell you that BMI is total BS. It really doesn’t measure how fat you are. No, it doesn’t. It wasn’t designed to do that. According to the Centers for Disease Control (CDC), it is not supposed to be diagnostic of someone’s body fat or health. It gives a general idea of whether or not your weight can lead to health issues.

So, what really is the BMI? According to the CDC, the BMI is a person’s weight in kilograms divided by the square of height in meters. Since my world is feet and pounds, I got no clue how to do this. I found a calculator online by the National Institutes of Health. It makes figuring out my BMI much easier.

Now, if you are fit and muscular, the BMI probably won’t work well. However, if you are fat, like me, it is a good barometer of better health. When I started this journey at 323 pounds, my BMI was 52.1. Over half of me was fat. YIPES! I am thrilled to say, I am 272 pounds, and my BMI is now 43.9. I am considered obese.

I am looking forward to being overweight. In fact, I will celebrate being overweight (180 pounds). Let’s get real, I will celebrate anything, but this significant. It is also a significant weight loss on my part.

The BMI chart also helped me set my overall goal of 153 pounds. It puts me in the normal weight range. High normal, but still normal.

So, no, I don’t think the BMI is total BS once you know what measures. And when you are fat, it is another piece of data to help make healthy decisions.

Wishing you good health! And remember, be kind–especially to yourself.

LLC & Hazel

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