What is the Body Mass Index and is it the best measure of obesity? - CrowdScience, BBC World Service

CrowdScience listener Maik wants to know what the Body Mass Index is and what his BMI score says about his body.

Maik trains dogs for a living and wonders if, like different breeds of dog, we simply have different body types?

So, Marnie Chesterton comes up with some answers, talking to doctors about how the BMI is used and misused in clinical practice, and looks at some alternative methods for measuring our body composition. She also sits down with philosopher Kate Manne to discuss the realities of living in a fatphobic world.

We hear from Tonga in the South Pacific, where high BMI scores have labelled the country highly obese. But this is not necessarily how Tongans see themselves.

And Marnie finds out if the BMI will continue to be used across the world as an important health marker to say whether people are healthy, overweight or obese, or whether it is destined for the scrap heap of medical history.

00:00 How to calculate BMI
01:20 Listener Maik wants to know what BMI can tell you about your health?
02:20 How the WHO uses BMI to classify weight
03:05 History of BMI and its inventor
04:15 What the BMI tell us and why excess fat can be bad for our health
06:40 What other kinds of health screening are there? Marnie enters the BodPod
11:35 What Tongans think about their weight and the BMI
16:04 How useful is the BMI?
17:20 BMI and access to health care
19:10 Weight stigma, or fatphobia, and the BMI's role
21:40 The BMI classifications were changed in the late 1990s
24:14 Should we stop using BMI?

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[Pougie]

@14:00 In Tonga, and with many colonized countries, the issue is that they aren't eating their traditional native foods anymore. I have heard stories of native Alaskan ppl being sick on western foods going back to their native foods and after months to years they no longer have diabetes, high blood pressure, etc.

[mamakaka]

People need to grow a spine. Admit it. You are fat. I am fat. Life is not all rainbows and unicorns.

[marathorne]

It's a "cheap and cheerful" measure. Body fat composition is not accessible to everybody at home. Too much fat, particularly visceral fat, compromises health. BMI is far from perfect, but it's a starting point for further investigation.

[petervince]

I think waist-to-height and waist-to-hip ratios are better predictors of obesity risks. Clinical tests such as complete blood count, blood pressure, and other tests are more useful than bmi and the ratios mentioned above.

[dinimueter]

I think the BMI is a fairly good guideline for most people. It’s not perfect of course but I don’t get some of the criticism. Come on, everyone knows if they are more the type „bodybuilder“ or „couch potato“. And your doctor can see it. Serena Williams knows she’s not overweight but very muscular.
I don’t like how the guy from Tonga sugarcoats Tonga‘s high obesity rate. There’s a difference between larger build and obesity. In Tonga 13% of the people aged 20-79 have diabetes type 2. I watched a documentary about Nauru and how the obesity rate of its population skyrocketed after industrialized countries ruined their environment and started to supply them with cheap ultra processed foods. We need to address this issues instead of sugarcoating obesity. If you want to help marginalized people you need to find out why they are obese instead of claiming that by addressing the issue you are being racist.

[campflint]

We know that visceral fat is the real problem- too much increases the risk of a range of diseases. BMI is a rough but sometimes inaccurate screening tool for excess visceral fat. Not many people can afford an accurate but expensive, say, DEXA scan. That said, by the time one’s BMI is in the obese category, unless you’re a professional bodybuilder, you know you likely have too much visceral fat. No shaming here, just a medical condition to be addressed.

[stuartneil]

So at just over 6’ and 75kg I look skinny but have non alcoholic fatty liver disease. This despite running and some weights and feeling healthy at age 62. When In was slightly overweight according to BMI then the last time at 85kg it was less excercise and more biscuits, however I’ve been that with earlier in life with consistent work in the gym so it illustrates the points that you are making, that it’s a poor measure of my health.

[nowitfriends]

Thank you so much, this was an excellent overview 👌🏻

[careylee]

How about waist hip and waist height ratios?

[YPNOBATHS]

I was 102 kilos and with health of my dietician I reach my normal BMI . It's important to understand that you should be educated by career how to combinate the food. There's no meaning to be slim and to eat harmful products . Or your goals are only to lose your weight.

[LarryDiamond-teyt]

2:12 one of the biggest issues is this: ‘my neighbors can eat what they want’ and they are thin.

At minimum 50% of people, that are ‘normal’ BMI are significantly insulin resistant if not raging type 2.

We each have a ‘personal fat threshold’. Someone can have a BMI of 40 and less visceral or organ fat than someone with a 23 BMI. TOFI. Thin outside, fat inside.

But there is no health at every size. Too much adiposity even in safe subcutaneous fat, creates chronic inflammation.

So it’s the case in today’s world that many ‘normal’ BMI are as obese as the rest of us that can actually get obese.

I did reverse my morbid obesity. Noting fancy: tasty real food, intermittent fasting, falling in love with natural fat and salt. Not sexy, super effective.

But don’t chase weight loss. I was interested In health. When I found out I could eat steaks and broccoli lathered in butter, my success was assured:

Focus on transforming relationship with food, getting healthy, move better, sleep better, fast better. The weight loss follows 🥰🌞🥰

[asrafuldigital]

Nice very helpful video i am from India

[marathorne]

The word "diet" is now used to mean some (often faddy, drastic) short-term weight loss intervention that people either can't stick to at all, or cannot wait to revert back to their previous eating patterns - hence their high failure rate. If you adopt a healthy but satisfying eating pattern with a view to sticking with it FOR LIFE, you'll be able to keep the excess weight off once you've lost it. I believe the biggest enemy nowadays is ultra processed food, scientifically designed to encourage over-consumption of unhealthy chemical substances masquerading as food. It's really difficult to avoid consuming this stuff, it's ubiquitous and looks like the real thing (until you read the ingredient labels) but it's worth trying. "Garbage in, garbage out" doesn't just apply to computer programs.

[shyft]

Some countries use WHR and that seems to make much more sense, I think Japan does. Belly fat is a real killer, fat on your thighs (for a woman) is not

[galactic_socialist]

Remember Arnold Schwarzenegger had a BMI of 31 during the peak of his bodybuilding career
My physician doesn't buy into BMI but has to record it to get payment from the insurance company

[yucalin]

0:23 Isn’t it weight divided by square meters of height?

[BartBVanBockstaele]

As the video says: BMI is not and was never meant to be a measurement of health. Anyone who does that anyway, does not really know what he/she is doing. As is popular in computers: RTFM. That is always good advice.

[chooOne]

There had been so much fuss about BMI so much so that people become obsessed by it. But a low BMI is misleading. A regular consultation with one’s practitioner coupled with full bloodwork will help assess one’s health situation better. I for one has always had a low BMI only to find out my blood markers show otherwise; thin on the outside but “fat” on the inside. I find a regular check with my GP is more beneficial in catching underlying health issues early enough thankfully.

[ALEJANDROHERNANDEZRUIZ-sd]

"you ate your way in, you can walk your way out" Bill Burr

[gergohavasi]

I think it's another way not to take responsibility for our choices and actions. I especially dislike the argument that bodies come every shape size. Historically humans never had constant access to this amount of food. Preserving fat was a tool to survive famine, which occured regularly.
Now it's on us to say no to excess food, as our body is not smart enough to do so