Is Bmi An Effective Way Of Measuring Obesity?

[ToraToraTora]

For Ummmm and mikey et al.

[Buenchico]

It often seems to be people with a high BMI who rubbish it as a valid system of measurement. Similarly, they're never 'fat' but only 'big-boned', possibly with an 'undiagnosed thyroid problem' ;-)

See 'Limitations of the BMI' here
http://www.nhs.uk/Livewell/loseweight/Pages/BodyMassIndex.aspx

Also note this (from that link):
"Regardless of your height or BMI, you should try to lose weight if your waist is:
94cm (37ins) or more (men)
80cm (31.5ins) or more (women)

You are at very high risk and you should contact your GP if your waist is:
102cm (40ins) or more (men)
88cm (34ins) or more (women)"

[ummmm]

My BMI is 19 and I'm rubbishing it.

[Mamyalynne]

Your first comment is a bit sweeping Chris - I know many including health professionals who dislike relying on BMi and they are most certainly in the 'normal' camp re the figures used. For my own part, most of my life i have been classed via BMI as 'underweight' - at 62 (almost 63) I have just nudged into the lower end of 'Normal'.

The rest of your post I agree with and many other things need to be taken into consideration.

As I said on another thread (this is a split from that one) each person needs to be assessed individually.

[jno]

I have a high BMI and unfortunately it is not attributable to big bones, thyroid problems, excessive muscularity or concrete boots. None the less I've had operations and nobody's questioned my fitness to survive them (which to date I have done without any trouble).

[dannyk13]

Chico I have a measuring tape provided by the British Heart Foundation which has k section and a red section (danger zone) the measurements in the pink zone start 37" men, 31.5 women and the red zone start at 40" men , 34.5 women.One side of the tape is for Europeans and the other for Asians where the red zone starts at 35.25 men, 31.5 women.Why is there this difference?

[Buenchico]

Danny:
It's because the races have followed different evolutionary branches, resulting in different levels (and distributions of) subcutaneous fat, as evidenced by research such as this:
http://ajcn.nutrition.org/content/60/1/23.short

[Buenchico]

See also here:
https://www.hsph.harvard.edu/obesity-prevention-source/ethnic-differences-in-bmi-and-disease-risk/

[dannyk13]

Thank you Chico.Every day another snippet of knowledge.

[woofgang]

Gromit, its sad but IMO not unreasonable to prioritise life saving interventions over pain relief and to ensure that when people go for operations, the clinical risk is minimised...what’s not reasonable and what NHS England have "asked them to review" (which is NHSspeak for "You ain’t doing it pal”) is to deny people interventions based on body shape alone where they would allow that intervention on another person whose only difference was body shape.

[Hymie]

I’m boarder-line clinically obese, weighing 90kg with a height of 1.75m (5’9”).

I used to work out regularly in a gym and take other exercise; even now I still have quite pronounced calf and bicep muscles.

I have a 44 inch chest and 36 inch waist.

I would argue that there is a significant difference between myself and someone the same height and weight, with no muscle tone, a 36 inch chest and a 44 inch waist – but the BMI measure would see us as one and the same.

[woofgang]

Thinking about this, i reckon its a bit of brinkmanship by a manager who is totally fed up, knows they are on the way out and decided publicly spit his/her dummy out. The NHS as we all know, in the last instance, is controlled by the government and they know what the outcome would be of being the government who allowed this to become policy.

[theprof]

Let's add another snippet of knowledge shall we? Let's imagine a scenario where a person needs heart bypass surgery or even a heart transplant. The patient has for years suffered from heart failure and has also succumbed to liver disease as a consequence ( I won't go into the mechanics of how this happens). The patient has a BMI of 40+ due principally to the build up of abdominal ascites and leg and lung oedema.

So here we have a patient who needs vital surgery to continue to stay alive yet typically NHS cardiac surgeons could theoretically refuse to operate on the basis that he has an extremely high BMI. What a dilemma. Do you consider this fair?

This is a salutary lesson that not all high BMI patients can increase their chances of going under the knife by dieting. Dieting would not help this situation as intractable ascites has a very poor prognosis. The situation is commonplace within outpatient cardiac clinics throughout the country.

MrsProf is a leading Oxbridge Professor of Cardiology and encounters the situation I have outlined on a weekly basis. If this decision was up to the pen pushers currently controlling the majority of UK hospitals, no one in these circumstances would go under the knife and believe me, there's a lot of it about.

[theprof]

Buenchico, whilst the sentiments you express are admirable, I'd agree that your 1539 post is far to sweeping and broad. Yes, there are people who attribute their BMI to the reasons you cite, but it's far from the entire story as I outlined above.

High BMI does not always mean that the patient is busy eating too many pork pies. There are valid medical conditions that can result in the same and no amount of dieting will help these patients; I'm afraid your link is totally invalid for those with the cardiac conditions I outlined in my post. Patients should not all be tarred by the same brush.

[EDDIE51]

Thanks 'theprof' excellent answer and knowledgeable as always.

[douglas9401]

I hear that the Ryanair method has recently overtaken the BMi measurement when it comes to portliness.
Or am I missing something?

[Mamyalynne]

I doubt it Douglas.

[theprof]

Thank you EDDIE51. I'm very grateful.

I think sometimes I need to suggest a question to my local pub quiz team namely, "Which hospital department attaches the lowest credence to patient BMI figures". The answer is Cardiology. For those that consider that it's not true, I suggest they speak to a cardiac patient who has been regularly admitted to hospital 3 or more times a year for IV diuretic treatment. These patients are coming to the end of their natural life as Sqad said in a post earlier this week.