This is a tricky subject, because as this article mentions, BMI is an imperfect measure of health. So, we should probably stop using it. I am 26.2 BMI but I am an athlete. I have a higher body fat than I would like, particularly around parts of my mid section, but otherwise am in good heart health and all blood tests come back great. Yet, I will still be told to lose weight by most primary care doctors, based purely on BMI.
Unfortunately this fact has been hijacked by "fat positive" movements like Health at Every Size. They take this fact that BMI is an imperfect measure of health and stretch it waaaaay too far in my opinion, with most supporters translating it as "I can be healthy no matter how fat I am," which is definitely not true. There is an absolutely positive correlation with body fat, weight, and health. Unfortunately sane discussion on this is practically impossible no matter where you stand.
Would it be reasonable to say that BMI is a bad measure at an individual level, especially at values close to ideal range but at the same time it is a useful measure at population scale? As stated on the NHS Scotland website:
"BMI is used to categorise people’s weight. BMI charts are mainly used for working out the health of populations rather than individuals.
Within a population there will always be people who are at the extremes (have a high BMI or low BMI).
A high or low BMI may be an indicator of poor diet, varying activity levels, or high stress. Just because someone has a ‘normal BMI’ does not mean that they are healthy.
BMI doesn’t take account of body composition, for example, muscle, fat, bone density. Sex and other factors which can impact your weight can also lead to an inaccurate reading. As such a BMI calculation is not a suitable measure for some people including children and young people under 18, pregnant women and athletes."
> Unfortunately this fact has been hijacked by "fat positive" movements like Health at Every Size. They take this fact that BMI is an imperfect measure of health and stretch it waaaaay too far in my opinion, with most supporters translating it as "I can be healthy no matter how fat I am," which is definitely not true.
"Health At Every Size" was how it started, encouragement that you can improve your health despite not losing weight. For example, if you don't normally work out but decide to start, you're probably going to gain weight first - adding muscle faster than you lose fat.
"Healthy At Every Size" is the corrupted version you're describing.
> For example, if you don't normally work out but decide to start, you're probably going to gain weight first - adding muscle faster than you lose fat.
It takes at least a month to get your CNS firing correctly before your body can possibly build muscle in any significant way.
If you don’t work out and then you start, and you gain weight, you’re eating poorly, not gaining muscle.
I think that such “fat positivity” is not necessarily an organic grassroots phenomenon, rather it might be a consequence of the modern ad-driven internet. Celebrating personal expression, underdogs and minorities (and the obese can be slotted in alongside these) is something that advertisers love. Perceived negativity and judgement, on the other hand, could threaten advertiser relationships.
I never thought about it from this angle. I personally think celebrating body positivity is a good thing, but as it correlates to health, I think it can become harmful. IME there are a TON of "body positive" fat-focused influencers but I'm not sure a fat shaming influencer or even one that was criticizing the pro-fat movement would ever survive on social media, but maybe I'm wrong. I don't follow the young tiktok trends.
Yes, but a large component of worse health outcomes is due to bias on the part of healthcare workers.
Overweight people frequently have their problems ignored or downplayed, or given treatments for issues that they aren't experiencing, which leads to worse health outcomes.
I'm not denying that being overweight can be bad for one's health, just pointing out that when doctors provide worse treatment to a group of people that group has worse health outcomes and makes obesity more dangerous that it would be in a world without weight stigma.
Yea, my dad died of something similar - was morbidly obese among a lot of other problems towards the end of his life, they attributed a lot of those problems solely to his weight, but it turned out he had severe obstructive sleep apnea that was never treated. Had it been, I think his outcome would have been a little bit different. he was never even tested. We'd been telling him for years to get it looked at but his doctor convinced him the issue was weight.
I actually thought you were preaching the same thing as the ones you are criticizing later on.
I agree that there is people with a high BMI that are quite healthy. So this is not a perfect indicator of health. Sure.
But those people are a minority.
At the scale of a country of ~346 millions people, having 3/4 of adults with a high BMI is a clear sign of an unhealthy population.
And, yes, unfortunately, some people decided that, because BMI doesn't work with a minority, we shouldn't care about it and, furthermore, shouldn't care about body composition.
Exactly this. Athletes are an outlier when it comes to BMI.
Furthermore, I reckon the majority of the people discussing BMI, as in these comments, would tend to be outliers, too, based solely on the fact they care/understand.
The majority of the population has no fucking clue, and can’t even read nutrition labels. And I am not blaming them. This stuff should be taught in school—basic nutrition education.
I will disagree here, athletes aren't the only one who can have a BMI > 25 and still be healthy, I'm at 26.2 now (down from 34) and my body fat is in the healthy range. BMI is actually just a poor indicator, hip/waist ration is as easy to calculate and is better imho.
BMI is quite useful and fairly accurate for your average American, it probably covers 90% of us who engage in little to mediocre amounts of physical exercise. Everyone knows it’s for average people and not physical exercise enthusiasts, those people are into healthy enough to know they aren’t fat. BMI is an easy measure for doctors and patients to get a rough estimate. Your PCP will not tell you to lose weight if you show him your abs and pecs. Obviously this implies in-person doctors.
BMI, Both-Might-Indicate lots of muscles or fat stores. I can see how someone lugging lots of muscle mass around would want their own number - a BMI is either a credit score or a debt score, its absolute value means nothing. What if we did started to put a + or - in front of the number, if there was more muscle than fat being stored.
> I can see how someone lugging lots of muscle mass around would want their own number
Healthy people with high BMI are not how they are by accident, they don't care about their BMI because they know why it's high and they know it's not an issue
> General Mills has toured the country touting anti-diet research it claims proves the harms of “food shaming.” It has showered giveaways on registered dietitians who promote its cereals online with the hashtag #DerailTheShame, and sponsored influencers who promote its sugary snacks. The company has also enlisted a team of lobbyists and pushed back against federal policies that would add health information to food labels.
I wonder if that was part of the inspiration for the South Park special "The End of Obesity" [1]? A big part of that involved companies that sell sugary foods pushing body positivity so people wouldn't cut down on their foods.
My weight has fluctuated all my life, to my consternation. I do feel the health differences.
Something that helps me is body shaming. (Making a serious point here.) I have a sense of humor about life’s challenges and get a motivation boost from comments by strangers or familiars.
I personally value the motivation aid, as motivation is often hard to manufacture. I find comments & judgements hilarious, as long as they reflect reality, and have no practical impact.
I don’t judge my worth on my weight, but on my unstoppable optimism that yes, once again for the nth time, I am confident in my power to solve that problem, when time & circumstances allow. And until then? I am working on something else, worthy of progress.
At a particularly poor time in my body composition state, I initiated a turnaround by telling a friend I had really enjoyed being fat for the last several years, but thought it might be nice to be skinny for a change. His laughter played into my making a real commitment, that I followed through on.
Our brains are idiosyncratic things.
I think an instinct/habit to consciously hold two or more orthogonal and opposite viewpoints about all serious things, keeps our world views and option awareness nimble.
I have minority friends (of various blends) who are completely insensitive to mild discrimination most of the time. Just expect a fraction of people can’t get past pointless categorization and judgements. They either ignore it, to the point of looking right past it, or laugh or smile politely but pointedly in a way that draws attention to infractions in a way that disarms. People are often surprised by being called out, but not being shamed, discounted, or their immediate purpose side tracked in any way.
Humor and a thick skin go a long way in life to protect our mental & social health.
[Absolutely not making light of shaming or belittling anyone. We are not born with all the armor we need. But it is useful to know that our reactions to smaller expressions of rudeness can take positive forms, even provide opportunities to give unconfrontational feedback. They don’t have to undermine us.
The best victories are achieved by finding a stance that lets us master conflicts we encounter without need for concern or motion.]
> While the prevailing viewpoint once was that obesity was merely a problem of calories in and calories out, and that people simply needed to eat less and exercise more to lose weight, the reality is much more nuanced, Dr. Armstrong said.
> “Obesity comes from genetic, physiological and environmental interactions,” she said. “It’s not the fault of any one individual who has the disease.”
> There are many potential drivers behind the skyrocketing rates, including the wide availability of ultraprocessed foods, the challenges to accessing fresh fruits and vegetables and an increase in sedentary online activity.
Is it just me or is this completely contradictory? Obesity is just a matter of how many calories you ingest relative to how much you burn. The doctor says this is inaccurate, but then goes on to say that people are simply eating less healthy and exercising less. That is literally the point.
> Should a true national security emergency arise, America lacks the ability to mobilize as Israel and Russia have done. The Individual Ready Reserve (IRR) — comprising former active duty or selected reserve personnel who could be reactivated by the Secretary of Defense during wartime or a national emergency — is designed to act as a bridge from the AVF to a revived draft. Almost forgotten even by servicemembers, the IRR earned brief notoriety when some servicemembers were “stop-lossed” during the Iraq War — pulled from the IRR and returned to active duty involuntarily, usually to deploy again.
> Today, there are just over 264,000 servicemembers in the entire IRR. The Army’s IRR pool has shrunk from 700,000 in 1973 to 76,000 in 2023. Forget building new units in wartime: the IRR is now incapable of even providing sufficient casualty replacements for losses from the first battles of a high-intensity war.
> And even if more Americans could be encouraged to sign up, they may not be able to serve. Before Covid, fewer than three in 10 Americans in the prime recruiting demographic — ages 17 to 24 — were eligible to serve in uniform. Those numbers have shrunk further since the pandemic began. Only 23 percent of young Americans are qualified to enlist without a waiver, based on the most recent data. Endemic youth obesity, record levels of physical unfitness, mental health issues exacerbated by the Covid pandemic, and drug use have rendered the vast majority of young Americans ineligible for military service. Scores on the ASVAB — the military’s standardized exam for recruits, which tests aptitude for service — plummeted during the pandemic.
Turns out, if you don't build a system for your human pipeline to thrive, it comes back to bite. You can only neglect it for so long until the system goes from hobbling along to system failure.
The US has huge active duty, Guard, and Reserve groups in all branches that can and do deploy regularly. The AF in particular regularly performs logistics exercises just to practice and demonstrate the ability to deploy and fight quickly.
Readit News
Unfortunately this fact has been hijacked by "fat positive" movements like Health at Every Size. They take this fact that BMI is an imperfect measure of health and stretch it waaaaay too far in my opinion, with most supporters translating it as "I can be healthy no matter how fat I am," which is definitely not true. There is an absolutely positive correlation with body fat, weight, and health. Unfortunately sane discussion on this is practically impossible no matter where you stand.
"BMI is used to categorise people’s weight. BMI charts are mainly used for working out the health of populations rather than individuals.
Within a population there will always be people who are at the extremes (have a high BMI or low BMI).
A high or low BMI may be an indicator of poor diet, varying activity levels, or high stress. Just because someone has a ‘normal BMI’ does not mean that they are healthy.
BMI doesn’t take account of body composition, for example, muscle, fat, bone density. Sex and other factors which can impact your weight can also lead to an inaccurate reading. As such a BMI calculation is not a suitable measure for some people including children and young people under 18, pregnant women and athletes."
If the norm was to be like OP, then BMI would not be useful at scale.
Given that you need to know the outcome to determine if the measure is valid, it rather defeats the purpose of using the measure at all.
"Health At Every Size" was how it started, encouragement that you can improve your health despite not losing weight. For example, if you don't normally work out but decide to start, you're probably going to gain weight first - adding muscle faster than you lose fat.
"Healthy At Every Size" is the corrupted version you're describing.
It takes at least a month to get your CNS firing correctly before your body can possibly build muscle in any significant way.
If you don’t work out and then you start, and you gain weight, you’re eating poorly, not gaining muscle.
Overweight people frequently have their problems ignored or downplayed, or given treatments for issues that they aren't experiencing, which leads to worse health outcomes.
I'm not denying that being overweight can be bad for one's health, just pointing out that when doctors provide worse treatment to a group of people that group has worse health outcomes and makes obesity more dangerous that it would be in a world without weight stigma.
I actually thought you were preaching the same thing as the ones you are criticizing later on.
I agree that there is people with a high BMI that are quite healthy. So this is not a perfect indicator of health. Sure. But those people are a minority. At the scale of a country of ~346 millions people, having 3/4 of adults with a high BMI is a clear sign of an unhealthy population.
And, yes, unfortunately, some people decided that, because BMI doesn't work with a minority, we shouldn't care about it and, furthermore, shouldn't care about body composition.
Furthermore, I reckon the majority of the people discussing BMI, as in these comments, would tend to be outliers, too, based solely on the fact they care/understand.
The majority of the population has no fucking clue, and can’t even read nutrition labels. And I am not blaming them. This stuff should be taught in school—basic nutrition education.
Healthy people with high BMI are not how they are by accident, they don't care about their BMI because they know why it's high and they know it's not an issue
Not how a metric centred around 22.5 works.
The tricky part is getting people to understand bell curves, standard deviations, and outliers when explaining why a policy is the way it is.
I assume you mean a positive correlation between body fat and weight, and a negative correlation with either of these metrics to overall health?
https://www.washingtonpost.com/wellness/2024/04/03/diet-cult...
[1] https://en.wikipedia.org/wiki/South_Park:_The_End_of_Obesity
Something that helps me is body shaming. (Making a serious point here.) I have a sense of humor about life’s challenges and get a motivation boost from comments by strangers or familiars.
I personally value the motivation aid, as motivation is often hard to manufacture. I find comments & judgements hilarious, as long as they reflect reality, and have no practical impact.
I don’t judge my worth on my weight, but on my unstoppable optimism that yes, once again for the nth time, I am confident in my power to solve that problem, when time & circumstances allow. And until then? I am working on something else, worthy of progress.
At a particularly poor time in my body composition state, I initiated a turnaround by telling a friend I had really enjoyed being fat for the last several years, but thought it might be nice to be skinny for a change. His laughter played into my making a real commitment, that I followed through on.
Our brains are idiosyncratic things.
I think an instinct/habit to consciously hold two or more orthogonal and opposite viewpoints about all serious things, keeps our world views and option awareness nimble.
I have minority friends (of various blends) who are completely insensitive to mild discrimination most of the time. Just expect a fraction of people can’t get past pointless categorization and judgements. They either ignore it, to the point of looking right past it, or laugh or smile politely but pointedly in a way that draws attention to infractions in a way that disarms. People are often surprised by being called out, but not being shamed, discounted, or their immediate purpose side tracked in any way.
Humor and a thick skin go a long way in life to protect our mental & social health.
[Absolutely not making light of shaming or belittling anyone. We are not born with all the armor we need. But it is useful to know that our reactions to smaller expressions of rudeness can take positive forms, even provide opportunities to give unconfrontational feedback. They don’t have to undermine us.
The best victories are achieved by finding a stance that lets us master conflicts we encounter without need for concern or motion.]
Deleted Comment
> “Obesity comes from genetic, physiological and environmental interactions,” she said. “It’s not the fault of any one individual who has the disease.”
> There are many potential drivers behind the skyrocketing rates, including the wide availability of ultraprocessed foods, the challenges to accessing fresh fruits and vegetables and an increase in sedentary online activity.
Is it just me or is this completely contradictory? Obesity is just a matter of how many calories you ingest relative to how much you burn. The doctor says this is inaccurate, but then goes on to say that people are simply eating less healthy and exercising less. That is literally the point.
The potential of governmental regulation is incremental at best, and a deflection at worst.
https://www.vox.com/future-perfect/368528/us-military-army-n...
> Should a true national security emergency arise, America lacks the ability to mobilize as Israel and Russia have done. The Individual Ready Reserve (IRR) — comprising former active duty or selected reserve personnel who could be reactivated by the Secretary of Defense during wartime or a national emergency — is designed to act as a bridge from the AVF to a revived draft. Almost forgotten even by servicemembers, the IRR earned brief notoriety when some servicemembers were “stop-lossed” during the Iraq War — pulled from the IRR and returned to active duty involuntarily, usually to deploy again.
> Today, there are just over 264,000 servicemembers in the entire IRR. The Army’s IRR pool has shrunk from 700,000 in 1973 to 76,000 in 2023. Forget building new units in wartime: the IRR is now incapable of even providing sufficient casualty replacements for losses from the first battles of a high-intensity war.
> And even if more Americans could be encouraged to sign up, they may not be able to serve. Before Covid, fewer than three in 10 Americans in the prime recruiting demographic — ages 17 to 24 — were eligible to serve in uniform. Those numbers have shrunk further since the pandemic began. Only 23 percent of young Americans are qualified to enlist without a waiver, based on the most recent data. Endemic youth obesity, record levels of physical unfitness, mental health issues exacerbated by the Covid pandemic, and drug use have rendered the vast majority of young Americans ineligible for military service. Scores on the ASVAB — the military’s standardized exam for recruits, which tests aptitude for service — plummeted during the pandemic.
Turns out, if you don't build a system for your human pipeline to thrive, it comes back to bite. You can only neglect it for so long until the system goes from hobbling along to system failure.
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