![]() So should we just ignore BMI? Not necessarily, says Carl Lavie, a Louisiana-based cardiologist and author of the new book The Obesity Paradox: When Thinner Means Sicker and Heavier Means Healthier. In his recent book Fat Politics: The Real Story Behind America’s Obesity Epidemic, political scientist Eric Oliver reports that the chairman of the NIH committee that made the decision, Columbia University professor of medicine Xavier Pi-Sunyer, was consulting for several diet drug manufacturers and Weight Watchers International. But critics noted that those guidelines were drafted in part by the International Obesity Task Force, whose two principal funders were companies making weight loss drugs. In 1998, the National Institutes of Health lowered the overweight threshold from 27.8 to 25-branding roughly 29 million Americans as fat overnight-to match international guidelines. “That is actually what is healthiest for middle-aged Americans.”Īnd get this: While epidemiologists use BMI to calculate national obesity rates (nearly 35 percent for adults and 18 percent for kids), the distinctions can be arbitrary. ![]() “The World Health Organization calls BMIs of 25 to 29.9 overweight,” says Paul McAuley, an exercise researcher at Winston-Salem State University. These results were even more pronounced for middle-aged and elderly people. A 2013 meta-analysis by the National Center for Health Statistics looked at 97 studies covering nearly 3 million people and concluded that those with overweight BMIs were 6 percent less likely to die in a given year than those in the normal range. In fact, patients with heart disease and metabolic disorders whose BMIs classify them as overweight or mildly obese survive longer than their normal and underweight peers. There’s just one problem: A higher BMI doesn’t necessarily mean you’re less healthy. Doctors typically use BMI to advise their patients: If you’re below 18.5, you’re underweight 18.5-24.9 is normal 25-29.9 is overweight and 30-plus is obese. Insurance companies use it to set premiums: A 2013 report from the provider eHealthInsurance found that people with BMIs in the “obese” category paid 22 percent more, on average, than those in the “normal” range. When primary-care physicians record your height and weight, as required by law, the electronic record they see displays your BMI. Today, BMI is still one of the most commonly used measures of health. This formula, known as body mass index (BMI), spread from insurers to health researchers and finally, in the 1980s, entered the clinical realm. They searched for a way to measure excess fat and hit upon a simple formula developed in 1832 by a Belgian statistician, mathematician, and astronomer named Adolphe Quetelet: Simply divide a person’s weight by the square of his height. Insurance companies noticed that their fattest policyholders were significantly more likely to die early than those of average weight. Shortly after World War II, it became clear that eating too much food led to just as many problems as not eating enough. But as farms industrialized and food became cheaper, the tables began to turn. ![]() Doctors were far more worried about underweight Americans, many of whom were too poor to afford enough calories. It wasn’t so long ago that fat people were considered healthy.
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