Insurance companies and the government and the news-media seek to educate the public about the “body mass index”(BMI). The only people not talking about BMI are the weight loss physician experts.
–because the BMI is inaccurate.
Weight loss physicians care about obesity because obesity can cause cancer, heart attacks, and strokes. Obesity causes hypertension, diabetes, fatty liver, and cholesterol and triglyceride problems. Those risk factors create the greatest concern.
For this reason, it is important to use an accurate measure to define “obesity”. If an inaccurate measurement like the BMI is used, an insurance company might label someone “obese” who is not obese. A healthy person may be denied health insurance.
At the same time, obese people with normal BMI are incorrectly told they are healthy. I have seen many patients who knew that their belly fat was not healthy, but they were told not to worry because their BMI was normal. After full evaluation, I have found them to have fatty liver, elevated triglycerides, and insulin resistance, putting them at risk for diabetes, breast cancer, colon cancer, heart attacks, and strokes.
Instead, weight loss physician experts use measurements of body-fat-percent and/or waist size (or waist-to-height ratio). Some physicians have shamefully admitted that they report a patient’s BMI in the medical record merely to satisfy the insurance companies or governmental regulators, even though the physician knows that the BMI is of limited value.
Japanese researchers recently performed an analysis of data which showed that the BMI accurately predicted obesity risk factors only 36.3% of the time. Meanwhile, the waist-to-height ratio predicted obesity risk factors up to 80.5% of the time.
Urgency of reassessment of role of obesity indices for metabolic risks.
For accurate medical information, who do you turn to?
A) the news media
B) your insurance company
C) the government
D) weight loss physician experts
… Choose wisely.
In another, more recent study, they showed that patients who had high percentage of body fat in the trunk had higher risk of diabetes … even if they were “normal” weight. This really calls into question using weight as an indicator of health risk, when there are more accurate indicators.
“Association of central adiposity with prediabetes and decreased insulin sensitivity in rural Chinese normal-weight and overweight women.”
In an even larger study, more than 10,500 individuals were evaluated. In this very large study, looking at cardiovascular events and mortality, the results were so impressive that the researchers wrote in conclusion: “Waist-to-height-ratio represents the best predictor of cardiovascular risk and mortality, followed by waist circumference and waist-to-hip-ratio. Our results discourage the use of the BMI.”
The predictive value of different measures of obesity for incident cardiovascular events and mortality.