Body-mass indicator confuses both physicians and patients

By JODI UPTON, Gannett News Service

http://www.theithacajournal.com/new...ews/148780.html

Detroit Lions quarterback Joey Harrington overweight? Dr. Robert Atkins, late founder of the popular diet, obese?

These are the conundrums that the BMI, or body mass index, has left us with. Currently, it's the most widely used measurement of obesity worldwide.

The BMI is not perfect. It doesn't take muscle mass or fat composition into account, which is why someone overweight can have the same BMI as an elite athlete like Harrington. And illnesses that can cause fluid retention, such as in Atkins' case, can also wreak havoc.

The index was invented in 1835 by a Belgian to calculate body volume. It's pretty simple: your weight divided by the square of your height (on a metric scale). Eventually a scale was added, so the resulting number falls into one of four categories: underweight, below 18.5; 18.5 to 24.9 normal; 25 to 29.9 is overweight; and 30 and over is considered obese.

Originally, the index was thought too confusing for the public and for untrained doctors, but it has caught on anyway.

In Arkansas, starting this month, all schoolchildren will be measured once a year unless they get a parental waiver. Kids whose weights hover in the danger zone get a doctor's referral note sent home. New Jersey is following suit.

And last month, the Archives of Internal Medicine issued new guidelines for doctors saying every patient should be measured -- regardless of the reason for the visit -- and get weight recommendations.

What's more, the scale is set to white body types, according to an 11-year study in the Medical Journal of Australia. "Normal weight" may actually be a higher risk category for people of lighter body types, such as those from Asia, Southeast Asia and the Indian subcontinent.

But despite appeals for a more reliable gauge, the World Health Organization is standing by its BMI charts, calling them "international classifications," in a Lancet article.

Most recommend using the BMI as one measure among several you should go over with your doctor, such as waist circumference. If you have a high BMI but are very fit, your doctor may make no recommendations.

If not, be prepared for a prescription of a better diet and walking and a healthier lifestyle.

Originally published Friday, March 26, 2004

I have never used this, because it puts me as obese, even though if some "doctor" said I was obese I run him down (9 miles or more) and smack him in the head. With 19% bodyfat, I was told by the trainer not to worry about losing anymore weight, but when my weight is on a medical chart, it looks like I am "obese". According to the BMI, I am supposed to weight no more than 180 pounds.

Oh well,

Later,
wsgts

The BMI was never meant to be used for athletes such as you seem to be. It's only meant for people who do only moderate or no activities. It's pretty limited really. But I guess it's useful enough to make a quick and dirty general comparaison between people of similar cultural background and activity level.

According to BMI, my ideal weight would be 135. That is roughly the amount of muscle mass I have, according to my most recent measurement.

What would they suggest--perhaps I should cut off a limb?

Yep,
Even Waaayyyyy back when I was in the Army (15-20 years ago) I used to have to get a "pinch test" every six months because the BMI charts said I was "over weight". I was 6' tall and weighed 190-195lbs. I wore 33" pants and was by all accounts in very good shape. I'm not boasting, but I had then and still have a muscular build. The pinch tests always showed a body fat level of 12-14%. Now, I'm about 200lbs and a BF level of ~18%. I don't look fat and don't consider myself fat, but I'm afraid that the "war on obesity" will consider me fat and start to treat me as such. They will probably advise me to start eating "more fruits, vegetables, and whole grains" while discouraging "Red meat, eggs, butter, etc". Who knows, with all the tracking systems coming out you may need to "swipe" your drivers license to buy hamburger (or anything else). Your fat consumption may become monitored.

Ditto the cut off a limb idea. 135 lbs lean here, too. The thing is, if health is the goal, why design a tool that is only accurate for those who do little to no exercise?

I just noticed that the BMI chart makes no distinction between Men and Women. Is that true?

Later,
wsgts