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Old 07-05-2009, 11:57 PM   #3
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Join Date: Dec 2005
Location: Woodland, CA
Posts: 11,712

S/C/G: 295/200/175

Height: 5' 8"


Obviously, there are extremes, as Kira mentioned, but in either of those cases, you wouldn't NEED a scale/calculation to determine if the person was at a healthy weight. It would be apparent that the individual was drastically overweight or underweight, no matter what number on the BMI scale.

The issue comes in classifying people who are closer to the "underweight", "normal", and "overweight" ranges. There is nothing that indicates that if I have a BMI of 25.1, for example, and I lose 2 lbs to get into "normal", my health will improve. The BMI was originally formulated to look at populations, not individuals (as the NPR article mentions). Too many health professionals and individuals are taking those numbers as gospel, trying to hit normal ranges even if their bodies are telling them something different is what is right. Someone who is built with a very slim build and has a metabolism like a hummingbird may be MEANT to have a BMI that, for most people, is "underweight"...just as someone with a very thick, muscular build who is really active and has built a lot of muscle may be meant to have a BMI that for most people is "overweight". Applied to individuals, it just doesn't take enough into consideration.

I also find the BMI to be really, really arbitrary, especially since research is anything but solid on what BMIs are really associated with low health risks (though 23 - 28 seems to come up a lot, insurance tables created earlier in the century have lower numbers, and there's definitely not agreement on what range is the best in terms of life expectancy). If "normal" doesn't mean "most likely to live longest", what does it mean? And if we don't KNOW what BMIs are associated with the longest lifespans, why are we recommending that particular range to -every- patient?

In my ideal world, doctors would advise patients on a healthy, calorie-controlled diet and lots of exercise, and then disregard (or at least de-emphasize) the scale. If you are doing those two things, most likely you'll lose weight and settle into a healthy weight for you, whether you are a more "average" build and that falls into "normal", or if you're more of an outlier on build, moderately above or below it. Either way, focusing more on the behaviors and less on the scale would prevent patients from being discouraged by WEIGHT and help them focus on improving health, and isn't that what it's all about?
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Maintained Oct 2007-Sept 2011, then got pregnant. Our baby boy was born in May, to lose the baby weight!!
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