How useful is BMI? #shorts

This video clip was taken from podcast episode 197 — the science of obesity & how to improve nutritional epidemiology with David Allison, Ph.D.

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The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 40 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).

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[leebackus]

I love your posts Dr Attia. Your information is highly appreciated and valuable

[oskarioinonen]

Agree. Also the only BMI to use for anything is the Oxford scientist created altered 3D BMI that takes into account that a body is a 3 dimensional unlike the original formula assumes. Muscle, fat, other weight percentage and exact weight of each monitored makes more sense, I have kept those on Excel chart since 2011.

[dennisbrinkley]

Visceral fat, bone mineral density, and appendicular lean mass index are the three most important criteria for metabolic health.

I wonder why that is not the main discussion for annual physical.

[andrewrivera]

My GP completely dismissed my DEXA scan and my BMI calculated by weight and height was what he used as it turned out to be the determining factor for him recommending a statin…

[grovermartin]

You've got my vote! Based on my experience of my paternal grandmother's siblings, all but one of the 8 were rotund to roly-poly, high energy, and lived into their late 90s up to 102. Aunt Edna smoked 4 packs of cigarettes a day, but only lived to be 94. Aunt Evelyn lived to be 102, but she quit smoking at 55, so the old toad of her dreams would marry her. Only Aunt Florence died young, in her mid 70s. She was skinny as a rail and smoked 5 packs of unfiltered Pall Malls a day [or maybe they were Chesterfields]. My uncles were in their mid 90s.

They grew up eating hearty farmer's meals grown on the deep rich northeast Ohio soils in the days before "artificial" fertilizers and pesticides, if that has any bearing.

[alphacause]

Measuring waist to height ratio, using a cheap tape measure, is a better barometer for overall health than BMI. Yes, using a DEXA scan is the best tool, but it is expensive and often inaccessible to most people. So among the tools that are affordable and accessible to the common person, a tape measure is ideal. With that said, while BMI is a crude assessment tool, and it really doesn't tell you much if you are 10 to 20 pounds overweight, it does tell you something is wrong if you are way beyond the normal weight threshold. Once you exceed 50 lbs or more over the normal BMI, and assuming you do not have so much muscle as to make you a statistical outlier, you are kidding yourself if you think a BMI that high is not indicative of poor future health outcomes.

[BrandyWiseNL]

A Smart Scale measures more than just BMI. It is a global measure but you can still see your progress and it is affordable. My bones, muscles and fat are okay. 😊

[ecospider]

I asked my doctor to do a fat percentage test and they said they didn’t know how to get that done. I was fricken confused. So I just have a good quality fat calculating scales.

[oolala]

This sounds like why a lot of actually overweight and obese people with a lot of subcutaneous fat are not metabolically unhealthy. The population is near 70%, overweight and obese, but only about 8% of people are diabetic. It’s true that 80% of them are overweight, but it’s obviously not the fat alone. There is a genetic element that makes some people susceptible. Weight loss will be helpful for them, but their body will often fight it. Complicated.

[nichtsistkostenlos]

If you don't have the capability to do a DEXA scan, then BMI is an okay measurement for most people (waist to height ratio is even a bit better). If you have a BMI in the mid-40s, that's a pretty damn good indicator that you're highly unhealthy and should start doing something about it immediately. It gets weird when you start getting in the high 20's low 30's, but you're very muscular. Or you have high A1C/insulin sensitivity, but your BMI is in the normal range. At that point, DEXA scans provide a lot of insight about what's potentially going on with you and what you should do to improve your health from there.

[christiandavies]

Is there a way to add subcutaneous fat without adding visceral fat? It would make sense that humans have a way to healthily add some body fat for when food is scarce in the hunter gatherer times.

[dsha]

Are there any docs that actually do these tests that Peter talks about?

[timmothyburke]

I really want to know how gray hair might be an indicator of aging. If we are getting more gray hair what does that mean?

[janejohnston]

How much is a Dexa scan? BMI chart is free.

[Tempest]

Is there often a dramatic difference between visceral and subcutaneous fat when sex is taken into account?

[peterbedford]

BMI is a Public health level indicator

[RemtheEmpire]

Me sitting here with 18% body fat at 200 lbs thinking I should be using ozempic for my obesity

[darkdragonite]

I know Dr. Attia practices medicine.. but I really don’t believe that he doesn’t see some sort of correlation with someone’s BMI and their metabolic health. I practice as a nurse.. I know there are outliers to BMI (in which a high BMI could mean higher muscle mass).. but in general... someone with a higher BMI TYPICALLY is not in good health.

[peuple]

The fat percentage is the only important variable as well as muscle mass.

[ThroneRoom-od]

It's just a public health index, no big deal... It is what it is as it doesn't regard individual fitness composition. Professionals know this, no PSA necessary.- end of message-