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BMI was created by a man who was not a doctor, but was a giant racist. https://www.abc.net.au/news/2022-01-02/the-problem-with-the-body-mass-index-bmi/100728416
It may be right some of the time, not because it's actually good, but because that racist dip shit got lucky.
According to BMI I'm obese but I consider myself overweight. I still have a face, I have ankles and knees. I don't have backrolls. I can see my dick. If I'm obese then what the fuck is this:
BMI is correct for about 80% of people. The biggest problem is for people that are very tall, as you are 2 standard deviations from average height it works less well. The muscular argument is a fairly weak one, as the extra weight even as muscle can still be bad for your skeleton (and many that say they are muscular aren't 2+ standard deviations from average).
I'm slightly shorter than you, but the best I ever felt was when my BMI was on the edge of normal and overweight.
Are you visibly fat? If so, it works. The only time it doesn't is when you are visibly ripped.
It's a screening number. It's not supposed to be "trustworthy" because it doesn't mean anything other than as an arbitrary point for grouping individuals into categories that can be used to estimate risks and make generalized decisions.
As a thought experiment, consider another commonly used screening number, that breast cancer screening should become routine at age 40. Does that mean breast cancer doesn't happen to women below age 40? Of course not. Does it mean breast cancer will always happen eventually above age 40? Also of course not. What does it mean? Basically nothing. There is nothing magic or medically significant about being 40 years old specifically. It's just that we decide that's a good approximation of the time when the benefits start to outweigh the costs for most people.
For an individual it's a pointless number that is completely erased by a massive number of individual risk factors and situational factors. You are an individual. It does not apply to you.
For large populations, it's a decent generalization. For people working with large populations, it can be a very useful measurement. But it's not really supported to be anything more than that, and it's not particularly useful to apply to you individually. We do of course frequently apply it individually, including many doctors (usually following the direction of insurance companies who DO care about large populations and DON'T care about you as an individual), but that's not really particularly justifiable, that's just a reflection of how our health care system works (or doesn't).
The BMI was created by a social scientist to place people into rough categories for a study on how obesity impacts social interactions, in greater research on how the "average man" represented a social ideal. The fact that we now use it to define who is obese and overweight is a little insane. While it's been adopted by major health organizations (and hopefully adjusted by genuine health professionals), it is a horrible singular indicator of physical health. People in the extremes are statistically more likely to face health issues. This is not the same thing as "being in the obese category makes you unhealthy because you are fat."
BMI works for me, skill issue :P
Obese is just a medical term. BMI is a height to weight ratio so it's accurate in that way. It does miss as a measure of over-fat vs. overweight, but more often in the other direction (fat people with normal BMI) but it can err in the other direction sometimes, sure.
The easiest and most accurate way to tell if you are over-fat is waist to height ratio. Your waist circumference should be less than half your height. So if you are 198cm, waist needs to be less than 99cm. This is the only stat that's been a reliable predictor for health problems from too much fat (because it's the torso fat that's more problematic health-wise)
The other thing to remember is that the risk curve for underweight is steep but for overweight it's shallow - a couple extra kg has almost no extra health risk.
Afaik it's quite reliable as long as you're not very muscular. I'm 190cm and roughly 80-85kg, which is a quite normal (but a bit higher than avg) according to BMI. I also have a bit of a beer belly and definitely feel like I could lose some fat.
Unless you work out a lot and are muscular, I'd expect the classification of obese to be correct for your height and weight. 10cm taller than me and 35kg heavier doesn't sound like a weight within the healthy range unless it's muscle.
It's tricky,
It works well at a population level, and the reality is that most people with a BMI indicating that they're overweight are actually overweight
It doesn't account for muscle, bone density etc.
I have visible abs, but my BMI is overweight. It's because my bone density is unusual. I sink in water, and I have muscle
I also am middle-aged and have some fat that I didn't used to have
People like to write BMI off because it tells them something they don't want to hear. Everyone refers to athletes and the like, and I've upset plenty of people by saying "so, you're a professional rugby player, are ya?"
It's not perfect by any stretch, but it may give you something to consider
I have had people describe me as "skinny", when I'm definitely not. Especially Americans
Most people are so used to seeing fatties that a healthy person looks thin by comparison
pretty much this. though I'd also add that if one has a BMI high enough to be overweight, and aren't fat or at least a big doughy on the edges, one probably invests a great deal of time and energy keeping up on that body... and therefore wouldn't be asking or arguing the whole "i'm not fat" thing.
Yep
I work a reasonably physical job, I don't spend much time sitting, I'm very careful with my food (I've been fat before)
I could probably stand to lose a little weight, but I am more flexible, limber and agile than lots of blokes half my age, and I want to keep it that way
It's statistically correct, but not specifically correct. It doesn't tell you for certain that you, personally, have too much body fat (or too little fat/muscle), but it's a good indicator.
And that's really what you're looking at; you're trying to figure out if you have more body fat than you should.
Harpendens skin fold calipers--when used by a trained professional--will give you a more accurate measure of your overall body fat percentage. And InBody scale will measure bioelectrical impedance (essentially running a low-voltage current through you and measuring impedance) to give you a fairly accurate measure of your body fat percentage, but how well hydrated you are can significantly affect the reading. Hydrostatic underwater weighing was long been the gold standard for measuring body composition. BUT dual x-ray absorbiometry (DEXA) has overtaken it, because it's significantly easier on the person being tested.
That said, body fat alone doesn't tell you if you are actually healthy. You can be fairly low in body fat, and have horrific cardiovascular fitness. And being exceptionally heavily muscled, (say, 200kg, at 7% body fat; Mr. Olympia levels of muscle) doesn't appear to be healthy on your joints and heart either in the long term.
It's usefulness is in it's simplicity, not in the accuracy or precision at an individual level.
Especially if you like lifting weights you can get some wild errors.
BMI is kinda like IQ, certainly useful, but it doesn't tell the full story.
If it is high, you may be fat, if it is really low, you are definitely underweight.
BMI is kinda like IQ
But you want to be sure that your IQ is the higher number...
😆
I'd like my BMI to be higher as well though, I have to pay higher life insurance rates because mine is so low they've decided I am "at risk" despite being perfectly healthy :|
Waist-to-height ratio can help supplement the BMI measure without needing any special body fat scales or stuff like that.
It's also a really simple one to remember. Keep your waist circumference below half your height.
Our aim was to differentiate the screening potential of waist-to-height ratio (WHtR) and waist circumference (WC) for adult cardiometabolic risk in people of different nationalities and to compare both with body mass index (BMI).
[..]
Compared with BMI, WC improved discrimination of adverse outcomes by 3% (P < 0.05) and WHtR improved discrimination by 4-5% over BMI (P < 0.01). Most importantly, statistical analysis of the within-study difference in AUC showed WHtR to be significantly better than WC for diabetes, hypertension, CVD and all outcomes (P < 0.005) in men and women. For the first time, robust statistical evidence from studies involving more than 300 000 adults in several ethnic groups, shows the superiority of WHtR over WC and BMI for detecting cardiometabolic risk factors in both sexes.
"Supplement?" I would have said "replace."
Yeah, that would've been more on point.
To have a "normal" BMI my brother would need to lose all the fat he has, and chop off his leg. In a general case it's okay-ish. In specific circumstances it's totally rubbish.
BMI is generally useful as a form of shorthand for whether somebody is a healthy weight. Body composition, specifically body fat percentage, matters more. Bodybuilders often fall into the obese category for their height but you generally wouldn't call them fat.
The original BMI calculation has received criticism for classifying shorter people and taller people incorrectly. Shorter people end up with a BMI that is proportionally too low and tall people proportionally too high.
You're fairly tall, but still fall squarely in the overweight category with the new calculation (https://people.maths.ox.ac.uk/trefethen/bmi_calc.html). Even with the new calculation, it's still a shorthand method and won't be accurate in all situations.
For a more accurate picture of whether you may want to consider losing weight, a Dexa scan will determine you body fat percentage. General guidance is <20% for men and <25% for women.
Its flawed but a decent screener. Follow up with a blood test if you are concerned. BMI doesn't distinguish between muscle/fat and some people can have a high BMI but be metabolically perfectly healthy-others not so much. Its a very wide spectrum that needs to be looked at on a case-by-case basis. Also fat tissue (adipose) is involved in much more than just energy storage, its quite active in inflammation, metabolism and disease processes. Source: I did my MSc on obesity and gut health. Bonus fun fact: theres no standard definition of "high fat diet", many meta analyses are comparing wildly different diets to draw some pretty "interesting" conclusions!
A diet high in fat can be healthy. Imagine someone eating a couple avocados every day and saying they are being unhealthy. Eating fat does not make you fat. The low fat craze I believe started in the 90s and has continued. You know what they generally replace the fat with to make the food taste good? Sugar. Sugar is terrible for you. Far worse than fat.
I didn't mean this as an attack on you personally I just want to get this low-fat shit out of people's brains.
Again, its a spectrum. It depends on calorie density and types of fat, how you react to it. There are absolutely certain types that are straight up bad, some can be good.
the BMI was developed by a European data nerd who only measured white working class men from one country. it does not really account for deviations from that specific type of person, like gender, ethnicity, or musculature. all it can say is how your weight relates to your height, and the medical field has a real problem with treating patients like human beings, let alone accurately identifying someone's needs. so, uh, i wouldnt stress over your BMI
BMI is a massive oversimplification. It’s a fun stat to look at, but I wouldn’t make serious decisions built on it.
Depending on your frame your healthy weight could be “underweight” or “overweight” according to BMI scale.
It's like any other initial screening tool. It gets you started, but it can't be the main determinant for healthcare. BMI isn't meant to be an all-in-one measuring stick the way something like a blood test can be (most of them are first steps as well, but there's exceptions).
If a doctor has a patient with a 30 BMI, but they can see that you're at an otherwise healthy body fat level, they won't try and treat you based on the BMI unless they're on the shitty end of doctoring. There are bad doctors, but most of them get weeded out in the grinder that is med school and internship.
You'd definitely want to have other measurements to go along with BMI when you're unusually tall, short, or muscular.
...but also it's not really helpful to me in patient care. I tend to find height and weight used separately more useful for patient care than the BMI and even then I don't use them for much. The only time I really see a BMI that my brain does anything with is when it's 40+ and at that point they're almost certainly 300lb+ regardless of height and at that point the weight is still the most important piece of info I'm getting out of that section of the chart.
I think the highest BMI I've ever seen was 80something and at that point I'm more just telling the nurse version of a "big fish story" (that patient specifically is the one I use to illustrate the point of being given a patient with medical / mobility needs that is inappropriate to the type of unit I'm on and my efforts to give them some kind of safety and dignity being used by my administrators to justify continuing to leave them in that inappropriate environment, but that's a story for another day).
The caveat is that I'm not really doing too much with metabolism other than with my catatonia patients, and with them it's much more about keeping weight on than anything else. You actually very rarely see an acute eating disorder in inpatient psychiatry (if it's worth hospitalizing them, they need to be on a cardiac monitor and have somebody nearby who actually knows what's in the crash cart).
As an aside, while I did learn how to calculate a BMI in school, and most electronic medical records do it automatically and display it below the height and weight, most of the actual drug dose calculations either use weight directly (mg/kg) or use an even weirder and more complicated equation to estimate "body surface area" (BSA). You can google that equation but I neither need nor know how to calculate it (and again the computer does it for me). Other factors that seem to be used a lot for drug dose calculation are the age of the patient (both very young or very old patients often need less of something and get side effects more often), or specific diseases like kidney or liver disease can affect the dose too. How these specifically affect drug dosing is beyond me, but not being a doctor my best guesses are
Most of what I'm using the height and weight for within my own specialty is actually clothing / equipment sizes so I can have everything prepped for a new admission, and estimating how much literal weight is gonna get thrown around if they show up ready to fight. It's also helpful to know if medical is dumping another supermorbidly obese patient on us (they almost have to have psych issues to get that big, but they also almost always need mobility aids we don't have).
Other things I would care more about:
BMI is associated with things like heart disease, diabetes, hypertension, etc, but with those things there's also a bunch of other things like your specific sugar and fat and salt intake and your family history and what other medications you're on or what other vices you have and current lab tests and whatnot so even there, like another user said, BMI is more useful at a population / public health level than it is an individual one.
For the newly bred and nearly dead dosing is heavily dependent on rate of metabolism. This is why kidney and liver function are so important to dosage. If a person can't metabolize and clear out metabolites at a steady rate then it increases the bioavailability of a drug in the person's system and can lead to overdoses. I used to tell my lab students that there's no guaranteed way to tell how young kids are going to react to a medication just because their little systems are doing so much at wildly different rates.
Oh I know why, but how the specific dosages (like, actual numbers) are actually chosen sounds like more of an art than a science.
Yea the science is making the dosage ranges and the art is the caregivers administering the medicine and monitoring the patient. I like the science part but the art part is too stressful for me.
BMI works quite well for typical people.
Either you do so much more exercise than everyone around you that it's not a good fit for you, or you should take it as a warning sign.
If you think it's muscle and not fat, there's another test that you might like to try instead which is the waist to hip ratio. https://www.healthline.com/health/waist-to-hip-ratio
But if you want an honest appraisal of your fitness, just do a fun run. The shortish runs round a park with a bunch of normal people. Either you can keep up without killing yourself and everything is fine, or you're not as fit as you think.
For most average weight people, it's pretty accurate. At the extremes, it starts to fall off.
Taller people have higher BMI's, something to consider.
Which just means the BMI skews for taller or shorter people
BMI doesn't factor in muscle mass, so that's one thing to keep in mind.
BMI is for the ones who like statistics, and average, and putting people into categories.
In the "rare" ranges of height (low and high), that interpretation gets weird and often very wrong.
264 pounds is literally obese. Literally by definition for most normal humans. So yes, you are obese.
Yeah how about go call that guy obese, he weights over 400lbs
https://en.m.wikipedia.org/wiki/Haf%C3%BE%C3%B3r_J%C3%BAl%C3%ADus_Bj%C3%B6rnsson
Literally ways more the Homer Simpson and asks if BMI is accurate.
You're just big boned.
BMI doesn't take body fat % into consideration so no it's not a good measurement. Most bodybuilders would be called overweight or obese based on their BMI.