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Is obesity such a big, fat threat?


Cox News Service
Monday, August 30, 2004

WEST PALM BEACH, Fla. — BMI. It sounds like code for something kids might giggle about.

But it stands for body mass index, and lately it's become a joke to some people.

Just check out any BMI chart; they're widely distributed, many at doctors' offices. Most will have disclaimers that the index — a measure of body fat, judged by weight in relation to height — doesn't apply to athletes, whose muscle mass screws up the measurements. Or to the elderly, whose lack of muscle mass also screws up the measurements.

Hello? Are we listening, you insurance companies using the chart to determine rates? Fit people and old people are excluded, so exactly what good is this formula that magically tells us whether we're underweight, on target, overweight or obese? (And, by assumption, links weight to health problems?)

Not much, according to an emerging group of academics, who — while linked to The Center for Consumer Freedom, a restaurant industry coalition — say fat isn't necessarily fatal.

These days, that's almost heresy. Nearly 59 million Americans were rated obese in a recent government survey based on BMI statistics. And a similar survey of young people found that 15 percent of youngsters ages 6 to 19 were seriously overweight. While The Center isn't advocating that we all stuff ourselves uncontrollably, it is proclaiming that overweight, by itself, isn't the problem, and that the clamor to get us all on the BMI bandwagon is making us feel bad about our bodies, while doing a good job of promoting the weight-loss industry.

"The BMI is relatively useless as an indicator of health for individuals. Contrary to what we have been told by the government, there is a minimal relationship between increased BMI and health-related issues, except at the very extremes of the weight distribution (very, very fat and very, very thin)," says Dr. Jon Robison, an adjunct assistant professor at Michigan State University.

"The use of the BMI promotes an irrational focus on weight when the focus should be on health," Robison says. "People of all sizes and BMIs should be encouraged and assisted in living more healthy lives. Research at the Cooper Clinic in Dallas shows clearly that people can be fat and fit."

That's hard to believe, after all the propaganda we've gotten about how pounds kill.

Athletes are a clear indicator of BMI dysfunction. Check out the weight lifters who competed last week in the Olympics. While not all are massive, Cheryl Haworth is 5-feet-9 and weighs about 300 pounds.

That makes her obese by BMI standards. But the U.S. women's superheavyweight contestant lifted a total of 617 pounds, 22 more than she raised while medaling in Sydney, despite an elbow injury. She is clearly a fit woman.

To make its point about the arbitrary nature of BMI, The Center for Consumer Freedom (www.consumer

freedom.com) calculated some hunky actors' BMI scores. Guess what? Will Smith, Matt Damon, Hugh Jackman and Denzel Washington turn out to be overweight. Gov. Arnold Schwarzenegger stacks up as obese, as do Sylvester Stallone, Bruce Willis and Tom Cruise.

You wanna tell 'em?

MSU's Robison isn't the only educator who views the BMI as a misapplied tool.

Dr. Glenn Gaesser weighed in on the same side as Robison in the fall 2003 issue of Harvard Health Policy Review. He says the BMI "tells very little about lifestyle factors, such as physical activity and nutrition, that are far stronger correlates of health."

In the article, titled "Is It Necessary to be Thin to be Healthy?," Gaesser — professor and director of the kinesiology program at the University of Virginia — argues that, "There is a good deal of evidence indicating that many of the more prevalent weight-related health problems such as high blood pressure, elevated cholesterol and trigylceride levels, insulin resistance, and glucose intolerance, can be improved independently of weight loss."

You don't have to lose weight to be healthy, he believes. And the article argues that point.

But wouldn't life be boring if we could all agree?

Naturally, there are those on the other side of this fence, who find the BMI chart useful.

Two years ago, researchers at Brigham and Women's Hospital in Boston calculated the risk of stroke in terms of the BMI.

Men with a BMI of 30 or higher (obese by BMI standards) were found to be twice as likely to have a stroke compared with men who had a BMI of less than 23, a healthy weight.

"Our findings underscore the fact that your risk of stroke is modifiable when it comes to how much you weigh," said study author Dr. Tobias Kurth. "The prevention of stroke may be another benefit associated with preventing excess weight and obesity in adults."

Go figure.

Carolyn Susman writes for the Palm Beach Post.

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