Posted by: Chris Maloney | June 16, 2012

How Should We Determine Who’s Fat? Does The BMI Work? What Does Dr. Weil Think?

Two mice; the mouse on the left has more fat s...

Two mice; the mouse on the left has more fat stores than the mouse on the right. (Photo credit: Wikipedia)

If you’ve ever looked at weight, you’ve seen the BMI charts.  If you’ve somehow missed this particular joy, here’s an online way to find out.

But is the Body Mass Index accurate?  A weight lifter will show up off the charts on a BMI, possibly worse off than a couch potato because his muscle is denser and heavier.  People who have the thick build of a weight lifter but who are still overweight will show up on the BMI chart as much worse off than they actually are.

At the same time, a person can be amazingly unhealthy and still show up as a normal BMI.  To catch this researchers want to shrink the overweight section of the BMI chart down to make more people obese.

Dr. Weil admits that the BMI is inaccurate, and pushes for Leptin testing or using the same technology we use to test bone density.  But both are seriously limited.  The bone scan technology will only measure fat in a specific area, and Leptin levels vary, probably far more than we know.  The best plan Dr. Weil has is measuring hip to waist ratios, but even that is prone to wide error.

Instead of relying on technology, perhaps we need to simplify our testing.  Do you think you are overweight or obese?  Has your weight increased dramatically since your high school and college years?  Guess what?  You’re overweight.  You need to change directions.  It doesn’t matter what the scale or the BMI says.  It’s about maintaining your own normal levels.

Do you have difficulty moving because of weight?  Guess what?  You’re obese.

Whenever I talk to patients about weight, none of them have any illusions about where they stand in terms of weight.  So the discussion of how to measure weight is simply an academic one.  We need to refocus our attention on how to help people effectively change directions.

Hint:  it doesn’t involve badgering people about caloric restriction.  It DOES involve helping people deal with stress better and providing stress support for them, as well as supporting women’s hormones.  Why?  Because everything we have indicates that body fat has more to do with hormonal levels than caloric intake.  Read Good Calories, Bad Calories, or similar books to get a sense that the reality is hormonal, not caloric.




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