Feb 21, 2017 12:08PM
Can you be 'fat' — and fit?
For at least a decade, medical professionals have questioned whether or not a person can be both fit and healthy while being overweight. While many say that BMI is one of the easiest ways to get a quick picture of a person's health, some studies have indicated that simply measuring a person's body mass index can be misleading. Some individuals with higher BMIs can in fact have a higher level of fitness. Most research acknowledges that it's possible for people to have the same BMI but drastically different bodies and fitness measurements.
According to the U.S. Department of Health and Human Services, a person with a BMI of 25 or greater is overweight, while a person with a BMI of 30 or greater is obese. For a male that's 5 feet 10 inches tall, that's roughly 180 to 210 pounds to be "overweight," and more than 210 pounds to be "obese." Consider that a 5-foot-10-inch, 215-pound muscle-bound athlete with perfect blood pressure, low cholesterol and low body fat measurements could have the same BMI as an unhealthy pre-diabetic coach potato.
A recent study from UCLA found that nearly 54 million Americans may currently be labeled overweight or obese when they are in fact "healthy" by other measures. The CDC even found in its 2015 National Health and Nutrition Examination Survey that when measuring body fat percentage for 5,000 patients, BMI proved to be an incorrect indicator for roughly 18 percent of people. The survey revealed that 11 percent of those that were numerically overweight had normal body fat, known as "healthy obese," and that 31 percent of people with a normal BMI actually had excess body fat, known as "skinny fat."
"The public is used to hearing 'obesity' and they mistakenly see it as a death sentence. But obesity is just a number based on BMI, and we think BMI is just a really crude and terrible indicator of someone's health," says A. Janet Tomiyama, lead author of the UCLA study.
Tomiyama called the findings a "final nail in the coffin for BMI," and that it is a "deeply flawed" measure of health.
The simple BMI formula may very well be outdated considering it was devised by a Belgian mathematician in the 1830s, and has remain unchanged in nearly 200 years. New proposals have called for a "waist to height" ratio, saying it's a more accurate representation than BMI. Margaraet Ashwell, independent consultant and former science director of the British Nutrition Foundation, says that in general, keeping a waist circumference in inches to less than half of your height can increase life expectancy. Because BMI does not take into consideration the distribution of fat around the body, it also could be giving unhealthy people the perception that they're in good shape simple because their weight is within "normal" parameters. By a waist-to-height measurement, a 6-foot person should aim to have a waistline of not more than 36 inches.
The health implications of abdominal fat are well documented. Abdominal fat affects organs like the kidney, liver and heart, more than fat in other areas of the body. Most medical professionals say that regardless of weight or BMI, patients can improve their health by eating a proper diet, engaging in regular exercise and monitoring things like blood pressure, resting heart rate and cholesterol. Dr. Eduardo Grunvald, director of UC San Diego Weight Management Program, says that both patients and doctors should focus on improving health as much as shedding pounds.
"If one individual is only 20 pounds overweight but is metabolically unhealthy (for example, type 2 diabetes), and another is 40 pounds overweight but has no underlying health problems, the former may benefit much more from weight reduction," Grunvald says.
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