Fat Tuesday: A conversation about BMI

[ecupirate04]

www.misszoot.com/2012/06/19/where-i-finally-learn-the-lessons-about-the-scale-and-bmi-that-you-all-accepted-a-long-time-ago-part-1/#comment-899711

Back on that other board that shall remain unnamed. We hashed out that fact that 5'3 and 150ish lbs is not obese.

This girl is 5'3' and 143. Not obese.

[SallyJ]

I agree with both of these sentiments - especially about the scale lying. I am up 5 lbs, but down in pant size (cause the scale lies to me) which now also puts me at overweight according to BMI. Which I'm not:
(from MFP, bad quality)

[taratru]

Oh, sbp, you're so good at saying exactly what I'm thinking.

[arborgold]

Jun 19, 2012 9:16:01 GMT -5 asdfjkl said:

Sadly, I am going to be out of the office most of the day today, so I'll just get things rolling and then you all can fan the flames.

That girl in the blog is not overweight. She is one of those people who clearly has dense muscle mass. She's working out constantly. She's running 30+ miles a week. When people are talking about how BMI isn't a good indicator of whether you're overweight, this is the kind of person they're talking about.

But for like 99% of us who are not super-athletes doing 4-5 boot camps and running 30+ miles a week, it IS a good indicator. If you find yourself jumping to the examples of the dense muscular people with high BMIs as an explanation for your own high BMI, you should first ask yourself when the last time you completed an ironman was, or how many pull ups you generally do when you are at the gym EVERY MORNING. If you can't answer those questions with a straight face, BMI works just fine for you.

Also, when your doctor brings up your BMI, he's not doing it because he is unaware of the potential for BMI to be inaccurate. He's doing it because it's a neutral way to tell you you need to lose weight. Particularly for women who always get hung up on the aesthetics of losing weight and wont' respond well to a physician saying that he can see with his eyes that you are fat.

Ding ding ding.

There are a few people on this board who immediately come to mind (maybe because I've met them) for whom I think BMI is probably bullshit (gpointe - you're one of them. You look FAB, about I'm sure your BMI is telling you all sorts of bad things about your self). But for most of us (myself included), I'd say BMI is a pretty damn accurate indicator of where we are / should be.

Of course there are exceptions to the BMI rule - but the rule still exists, and it's a good one.

[housegeek]

She's overweight by 2 lbs. I fluxuate that Daily it seems. It's also clear that it's muscle weight and not fat. Ill second SBP.

[ttt]

Jun 19, 2012 9:16:01 GMT -5 asdfjkl said:

Sadly, I am going to be out of the office most of the day today, so I'll just get things rolling and then you all can fan the flames.

That girl in the blog is not overweight. She is one of those people who clearly has dense muscle mass. She's working out constantly. She's running 30+ miles a week. When people are talking about how BMI isn't a good indicator of whether you're overweight, this is the kind of person they're talking about.

But for like 99% of us who are not super-athletes doing 4-5 boot camps and running 30+ miles a week, it IS a good indicator. If you find yourself jumping to the examples of the dense muscular people with high BMIs as an explanation for your own high BMI, you should first ask yourself when the last time you completed an ironman was, or how many pull ups you generally do when you are at the gym EVERY MORNING. If you can't answer those questions with a straight face, BMI works just fine for you.

Also, when your doctor brings up your BMI, he's not doing it because he is unaware of the potential for BMI to be inaccurate. He's doing it because it's a neutral way to tell you you need to lose weight. Particularly for women who always get hung up on the aesthetics of losing weight and wont' respond well to a physician saying that he can see with his eyes that you are fat.

Well said.

People get so offended by the BMI scale - "I'm not overweight! Look at me! I look great!" Well BMI isn't about how you look - it's a medical scale based on your medical statistics. It's a general guideline, not an end-all, be-all for every single individual. And getting offended by it is silly - it's like saying "just because my blood pressure is 130/95, that doesn't mean I have high blood pressure!! I'm healthy and I work out!!"

[SallyJ]

I haven't done Iron Man, I can't run a mile without stopping to walk, and I can't do pull-ups unassisted. I aim for working out 6 days a week, but seem to land at 4 days a week. I am working on my strength, but I wouldn't consider myself as athletic as the girl in the blog post.

I would agree that BMI may work for some average people, and it can definitely help start the conversation with a doctor. However, BMI is being used by health insurance companies for EVERYONE which can be problematic for the young, tall, and athletic individuals. Perhaps though, that is more a problem with the state of our health insurance. I honestly think body fat percent would be a more accurate measurement of health than BMI.

[ringstrue]

I'm so sick of the whole BMI debate when the BMI standard ITSELF says it's not correct to use it for athletes.

[emilyj]

Jun 19, 2012 9:16:01 GMT -5 asdfjkl said:

That girl in the blog is not overweight. She is one of those people who clearly has dense muscle mass. She's working out constantly. She's running 30+ miles a week. When people are talking about how BMI isn't a good indicator of whether you're overweight, this is the kind of person they're talking about.

I'm on board with this girl on the "Fuck BMI" train because this is me. If you're friends with me on MFP, you see the workouts I do daily. Yesterday I swam 3800m. Today I'm going to try to deadlift 200lbs. Clearly I am *this* person, and after years of fighting against BMI, I am so prejudiced against it I will admit it is hard for me to look at it with a nonjudgmental eye.

I hate it. ;D

[Deleted]

Jun 19, 2012 9:28:10 GMT -5 SallyJ said:

I would agree that BMI may work for some average people, and it can definitely help start the conversation with a doctor. However, BMI is being used by health insurance companies for EVERYONE which can be problematic for the young, tall, and athletic individuals. Perhaps though, that is more a problem with the state of our health insurance. I honestly think body fat percent would be a more accurate measurement of health than BMI.

I agree that health insurance using BMI for everyon is a problem, especially as I read conflicting research. I have seen reports of studies that show being 5-10 pounds overweight has no negative impact on health. I'm sure there are studies that show the opposite. I'm obese, and that's bad, I know it, and I'm at risk of my feet falling off from diabetes, blah blah blah.

But are people who are active, have good numbers, and don't have excess belly fat really at a high risk for things like diabetes and heart disease because they carry an extra 10 pounds in their hips and thighs?

[y4m]

Jun 19, 2012 9:28:10 GMT -5 SallyJ said:

However, BMI is being used by health insurance companies for EVERYONE which can be problematic for the young, tall, and athletic individuals.

THIS is my issue. I work out 5-6 times a week at a very high intensity, and regular 10+ mile hikes have left my thighs and ass...dense. Don't tell me I don't qualify for your preferred health discount because my BMI is too high, when we both know that other better proven metrics (cholesterol, waist to hip ratio, body fat, etc.) would show I'm a lower health risk that an inactive skinny mini.

[ttt]

I'll point out that it's also not necessarily healthy to carry a ton of extra muscle. This is something that H's doctor said to him at his last visit. It's not nearly as harmful as extra fat, but just the sheer extra weight can stress your joints.

[pedanticwench]

[SusanBAnthony]

I agree that it is generally a good measure. It does seem like if a HI company is using it for discounts, you should have the right to appeal it and ask for other measures to be used.

Our HI uses cholesterol, BMI, BP, and blood sugar. If you are "healthy" for all of them, you get a 500$ discount per adult. For each category you miss, you can do a "healthy living" activity to get your money- choices are weight watchers, wearing a pedometer and tracking your weight, and health consulting with a nurse.

[Deleted]

Jun 19, 2012 9:46:03 GMT -5 asdfjkl said:

It's not being used in isolation though. And correct me if I'm wrong, but are you talking about it being used by life insurance or health insurance. I've had health insurance always through an employer so that could be different, too, but I've never been asked for my BMI by anyone other than my life/disability insurance companies.

y4m referenced health insurance. Yes, I have heard of health insurance companies giving discounts for people in the healthy BMI range. Also, even with life insurance, it's not a good indicator. Again, based on the research I've seen, a woman who has 10 extra pounds in her hips and thighs simply isn't at the same risk for diabetes or heart disease as the woman who carries 20 pounds around her belly. But both may fit into the overweight BMI.

[emmybean]

BMI is a single tool and shouldn't be used as the sole indicator of health the need for weight loss. The lines have to be hard and fast for this metric, but The reality is that there are outliers, and that any one person 5 pounds in to the overweight category isn't going to need a rascal and their foot hacked off from a bad case of the Sugar. But it is a good guide. And there is a big enough range that most people should be able to find a number in the normal/low end of overweight range that they are comfortable with.

My BMI is currently 22.8. My lowest BMI was 21.1. I look and feel better at this BMI than than I did 12 pounds lighter. My body shape has changed for the better pp (aside from my stomach). So even with the same person, BMI doesn't tell the entire story.

Of course if your doctor is talking to you about BMI, you are likely in need of losing quite a few pounds. Which is where it is good to look at. As a macro, not a micro metric of realistic weight.

[y4m]

Jun 19, 2012 9:51:05 GMT -5 @angryharpy said:

Jun 19, 2012 9:46:03 GMT -5 asdfjkl said:

It's not being used in isolation though. And correct me if I'm wrong, but are you talking about it being used by life insurance or health insurance. I've had health insurance always through an employer so that could be different, too, but I've never been asked for my BMI by anyone other than my life/disability insurance companies.

y4m referenced health insurance. Yes, I have heard of health insurance companies giving discounts for people in the healthy BMI range. Also, even with life insurance, it's not a good indicator. Again, based on the research I've seen, a woman who has 10 extra pounds in her hips and thighs simply isn't at the same risk for diabetes or heart disease as the woman who carries 20 pounds around her belly. But both may fit into the overweight BMI.

Yes I was disqualified for a preferred health insurance program through my employer based solely on my BMI (passed all the other tests - cholesterol, BP, etc. with flying colors). I think using BMI for underwriting is hugely problematic. Especially when waist to hip ratio is just as easy to measure and a better indicator of health outcomes.

[chichimi]

Jun 19, 2012 9:47:06 GMT -5 pennypenny said:

I am overweight. But when I look at the BMI charts for me to be at the very top of the normal range I have to weight 157 lbs. I have been this weight. It is extremely hard to maintain. I cannot deviate from a strict plan hardly ever. I am active. I work out 3 times a week and I eat healthy a majority of the time, but I can't seem to stay in what BMI considers a healthy range. I am that person that AngryHarpy described above. I don't have excess belly fat (I have a small waist) and my extra weight is in my hips, thighs, and legs in general. What about people like me?

I do know that carrying your weight anywhere other than your waist is better for your heart and other organs because you dont have high levels of visceral fat. Being pear or hourglass shaped instead of apple is advantageous.

[aurora]

Jun 19, 2012 9:57:04 GMT -5 y4m said:

...I think using BMI for underwriting is hugely problematic. Especially when waist to hip ratio is just as easy to measure and a better indicator of health outcomes.

I am not a fan of BMI at all, but to play devil's advocate there are also problems with waist to hip ratio. For example, my hips are very narrow so my waist to hip ratio is bordering unhealthy even though I have a lower-than-healthy percent body fat.

[emilyj]

Jun 19, 2012 9:42:34 GMT -5 ttt said:

I'll point out that it's also not necessarily healthy to carry a ton of extra muscle. This is something that H's doctor said to him at his last visit. It's not nearly as harmful as extra fat, but just the sheer extra weight can stress your joints.

But how much extra muscle are you talking about here? Because I would say yes, the Arnold Schwarzenegger's of the world are probably running this risk. The girl in this article? Not so much.

[ttt]

Jun 19, 2012 11:34:17 GMT -5 emilyj said:

Jun 19, 2012 9:42:34 GMT -5 ttt said:

I'll point out that it's also not necessarily healthy to carry a ton of extra muscle. This is something that H's doctor said to him at his last visit. It's not nearly as harmful as extra fat, but just the sheer extra weight can stress your joints.

But how much extra muscle are you talking about here? Because I would say yes, the Arnold Schwarzenegger's of the world are probably running this risk. The girl in this article? Not so much.

I have no idea - I'm definitely not an expert on this! Just going by what H's doctor said. He's not quite Schwarzenegger-size but he is definitely very muscular and a good deal of his weight is in muscle. His doctor said that while muscle is good and better than fat, still carrying around 20 extra pounds of muscle can put a strain on your body just from the actual weight of it.

[gpw]

Jun 19, 2012 9:55:31 GMT -5 emmybean said:

BMI is a single tool and shouldn't be used as the sole indicator of health the need for weight loss. The lines have to be hard and fast for this metric, but The reality is that there are outliers, and that any one person 5 pounds in to the overweight category isn't going to need a rascal and their foot hacked off from a bad case of the Sugar. But it is a good guide. And there is a big enough range that most people should be able to find a number in the normal/low end of overweight range that they are comfortable with.

My BMI is currently 22.8. My lowest BMI was 21.1. I look and feel better at this BMI than than I did 12 pounds lighter. My body shape has changed for the better pp (aside from my stomach). So even with the same person, BMI doesn't tell the entire story.

Of course if your doctor is talking to you about BMI, you are likely in need of losing quite a few pounds. Which is where it is good to look at. As a macro, not a micro metric of realistic weight.

I'm so not playing this today, lol! I'm just going to go ahead and sit next to emmy. My BMI puts me in the overweight range, and I, in fact, am overweight. I am also most likely healthier than some in my same category with my same BMI. Whatever. My trainer is obese. He's also smokin' hot. Again, whatever.

People get hung up on labels. I was guilty of that once, too. I was also guilty of being hung up on the scale. I no longer am. The BMI scale doesn't bother me. My bathroom scale doesn't bother me. If I feel like crap and can't make it through my daily workouts, that bothers me. If my doctor should come to me and say "we need to do something about this", it would bother me. He knows my diet and my workout program, so ... again...whatever.

also, thank you, arbor!

[y4m]

Jun 19, 2012 12:24:15 GMT -5 gpw said:

Jun 19, 2012 9:55:31 GMT -5 emmybean said:

BMI is a single tool and shouldn't be used as the sole indicator of health the need for weight loss. The lines have to be hard and fast for this metric, but The reality is that there are outliers, and that any one person 5 pounds in to the overweight category isn't going to need a rascal and their foot hacked off from a bad case of the Sugar. But it is a good guide. And there is a big enough range that most people should be able to find a number in the normal/low end of overweight range that they are comfortable with.

My BMI is currently 22.8. My lowest BMI was 21.1. I look and feel better at this BMI than than I did 12 pounds lighter. My body shape has changed for the better pp (aside from my stomach). So even with the same person, BMI doesn't tell the entire story.

Of course if your doctor is talking to you about BMI, you are likely in need of losing quite a few pounds. Which is where it is good to look at. As a macro, not a micro metric of realistic weight.

I'm so not playing this today, lol! I'm just going to go ahead and sit next to emmy. My BMI puts me in the overweight range, and I, in fact, am overweight. I am also most likely healthier than some in my same category with my same BMI. Whatever. My trainer is obese. He's also smokin' hot. Again, whatever.

People get hung up on labels. I was guilty of that once, too. I was also guilty of being hung up on the scale. I no longer am. The BMI scale doesn't bother me. My bathroom scale doesn't bother me. If I feel like crap and can't make it through my daily workouts, that bothers me. If my doctor should come to me and say "we need to do something about this", it would bother me. He knows my diet and my workout program, so ... again...whatever.

also, thank you, arbor!

I try hard to subscribe to this philosophy as well. It's a reason I use how my clothes fit or how many calories my heart rate monitor says I burned this week as a measure of my fitness instead of a number on the scale (or BMI by extension).

But once we're determining insurance premiums based on BMI, then it's about a lot more than just how I feel about my personal health.

[gpw]

Jun 19, 2012 12:29:47 GMT -5 y4m said:

Jun 19, 2012 12:24:15 GMT -5 gpw said:

I'm so not playing this today, lol! I'm just going to go ahead and sit next to emmy. My BMI puts me in the overweight range, and I, in fact, am overweight. I am also most likely healthier than some in my same category with my same BMI. Whatever. My trainer is obese. He's also smokin' hot. Again, whatever.

People get hung up on labels. I was guilty of that once, too. I was also guilty of being hung up on the scale. I no longer am. The BMI scale doesn't bother me. My bathroom scale doesn't bother me. If I feel like crap and can't make it through my daily workouts, that bothers me. If my doctor should come to me and say "we need to do something about this", it would bother me. He knows my diet and my workout program, so ... again...whatever.

also, thank you, arbor!

I try hard to subscribe to this philosophy as well. It's a reason I use how my clothes fit or how many calories my heart rate monitor says I burned this week as a measure of my fitness instead of a number on the scale (or BMI by extension).

But once we're determining insurance premiums based on BMI, then it's about a lot more than just how I feel about my personal health.

it took me a loooooong time to get there, trust me.

You are correct, though. I think basing insurance premiums based on BMI is flawed; especially if that is the only indicator. There are so many other things that can and should determine current (and future) health.

[Deleted]

Jun 19, 2012 9:20:16 GMT -5 arborgold said:

Jun 19, 2012 9:16:01 GMT -5 asdfjkl said:

Sadly, I am going to be out of the office most of the day today, so I'll just get things rolling and then you all can fan the flames.

That girl in the blog is not overweight. She is one of those people who clearly has dense muscle mass. She's working out constantly. She's running 30+ miles a week. When people are talking about how BMI isn't a good indicator of whether you're overweight, this is the kind of person they're talking about.

But for like 99% of us who are not super-athletes doing 4-5 boot camps and running 30+ miles a week, it IS a good indicator. If you find yourself jumping to the examples of the dense muscular people with high BMIs as an explanation for your own high BMI, you should first ask yourself when the last time you completed an ironman was, or how many pull ups you generally do when you are at the gym EVERY MORNING. If you can't answer those questions with a straight face, BMI works just fine for you.

Also, when your doctor brings up your BMI, he's not doing it because he is unaware of the potential for BMI to be inaccurate. He's doing it because it's a neutral way to tell you you need to lose weight. Particularly for women who always get hung up on the aesthetics of losing weight and wont' respond well to a physician saying that he can see with his eyes that you are fat.

Ding ding ding.

There are a few people on this board who immediately come to mind (maybe because I've met them) for whom I think BMI is probably bullshit (gpointe - you're one of them. You look FAB, about I'm sure your BMI is telling you all sorts of bad things about your self). But for most of us (myself included), I'd say BMI is a pretty damn accurate indicator of where we are / should be.

Of course there are exceptions to the BMI rule - but the rule still exists, and it's a good one.

Agree. I have a large frame--that just means I look and feel better at a BMI of 24 as opposed to 20.

Too bad I'm a fat kid and don't hit either anymore, ha!

[2vermont]

So, the girl in the OP: That was basically me in January....the heaviest I've ever been, but I wouldn't say "obese". I think if you all saw me at that time, you wouldn't call me obese either. I think it's the BMI labels that bother me. There is something about them that is just off.

Having said that, I would not and did not think I wasn't overweight. I knew I was overweight for me and needed to lose weight ASAP....and since then, I have lost 12 pounds.

[2vermont]

Jun 19, 2012 8:59:08 GMT -5 ecupirate04 said:

www.misszoot.com/2012/06/19/where-i-finally-learn-the-lessons-about-the-scale-and-bmi-that-you-all-accepted-a-long-time-ago-part-1/#comment-899711

Back on that other board that shall remain unnamed. We hashed out that fact that 5'3 and 150ish lbs is not obese.

This girl is 5'3' and 143. Not obese.

I'm now wondering....
I was very close to this a few months back. Are you sure that the BMI said that is Obese? Or Overweight?

[2vermont]

Jun 19, 2012 12:29:47 GMT -5 y4m said:

I try hard to subscribe to this philosophy as well. It's a reason I use how my clothes fit or how many calories my heart rate monitor says I burned this week as a measure of my fitness instead of a number on the scale (or BMI by extension).

Me too. I'm more psyched about the inches than the pounds I have lost.