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How do we judge a healthy weight range? BMI is no longer valid?
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This isn't true. Under 20 or over 25 BMI risk does increase, particularly for men. This is a meta-study with a total of over 10 million participants in 239 studies of weight and risk of death, "all cause mortality", so correlation no proven causation, but a large chunk of people studied.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30175-1/abstract
Fair enough. I'm not going to try nitpicking details about quality of the base studies or the aggregation of studies across varying population groups. Given that aggregation studies tend to balance out flaws in component studies, one would have to basically re-do the meta-study to assess the validity of their conclusions, and that could well go either way.Again, I want to say that I support aesthetic goals and do not believe you have any sort of obligation to get to the healthiest possible weight for your height.
I'm pretty sure 15% body fat will be close to optimum healthy weight, regardless of how much muscle I add to it.
What surprised me in this study was the increased death rate for those between 18.5 and 20 BMI, not the increase in overweight and obese. I would have thought that carrying less weight was healthier until you got to that 18.5, but that isn't borne out in the big study.
I would imagine that's 1. difference in resilience in the face of accident or disease, and 2. people in that group being more physically active and prone to risk taking.
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BMi is still pretty relevant for the vast majority of people. Personally I am more focused on my goal BF% than BMI or weight, but that doesn't make BMI invalid or misleading.
I'm 181cm and 104KG (down from 124.7kg) That puts me still in the obese 1 category at 32 BMI. I wear a size 36 jean and can squeeze into a 34, and large shirts, my waist by the tape at the navel, is 40. I am wearing clothes now I wore in the past, prior to when I started lifting, at around 210. 3 solid years of lifting before packing on weight, changed my BMI by maybe 3 points, well within the "spread" of the healthy range once I get there.
I called BMI outdated myself before because I didn't want to acknowledge how overweight and plainly fat I had gotten, I kept telling myself oh BMI doesn't work for me....I accept it now because it is still a decent indicator of how much I still need to lose...When I get to a muscular and athletic looking 15ishBF% I doubt I will care what the BMI chart says. You think Usain Bolt cares at all what his BMI is or complains it doesn't apply to him because "insert excuse, big boned etc"....Only overweight people who haven't quite yet faced up to things really complain about the "unfairness" or "validity" of the old BMI chart11 -
MarkusDarwath wrote: »
That will be down to the sheer number of people here trying to achieve the same thing. About as representative of the general population as celebrities (will have built up a multi-dimensional Venn diagram in my head by the time this thread fizzles out).
(And this is where I declare my preference, aesthetically, for lanky geeks!)6 -
stephenearllucas wrote: »
Though not actually that off. I'm quite lopsided due to accumulated injuries. Gammy right foot meant that my right shin was almost an inch smaller than my left, a while back, though I seem to have stabilised it,vfinally, after many years of embarrassing falls. Conversely, developed a massive right forearm compared with left, due to a combination of knitting style and arthritic left elbow!MarkusDarwath wrote: »BMI is just built off insurance risk tables though. Health risk increases over (or under) a given mass for a given height. Saying that Most People can't get a medical benefit from getting under a 25 BMI is nonsensical. All BMI is saying, literally (in the original sense of the word) is that Most People do get a health benefit from getting under a 25 BMI. What it doesn't say is which people are part of that "Most People" group.
Statistically speaking, most people -don't- get a particular benefit from being under 25BMI. The actual cutoff for increased risk is 30 for those without other health risk indicators, or 27-28 for those who do have other indicators (such as high blood pressure, glucose or cholesterol.)
The "overweight" category has no meaning by itself.
This isn't true. Under 20 or over 25 BMI risk does increase, particularly for men. This is a meta-study with a total of over 10 million participants in 239 studies of weight and risk of death, "all cause mortality", so correlation no proven causation, but a large chunk of people studied.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30175-1/abstract
"Mortality was lowest in the
BMI range from 20·0 kg/m² to less than 25·0 kg/m²,
and was significantly increased just below this BMI
range and in the overweight range just above it."
Again, I want to say that I support aesthetic goals and do not believe you have any sort of obligation to get to the healthiest possible weight for your height. All of us make compromises in some direction, nobody is doing 100% of the "right things" to be healthy. When you have information, though, you can make an informed choice about it. Overweight does increase health risk.
What surprised me in this study was the increased death rate for those between 18.5 and 20 BMI, not the increase in overweight and obese. I would have thought that carrying less weight was healthier until you got to that 18.5, but that isn't borne out in the big study.
Good luck to you in getting to your personal goals.
I think one of the more overlooked problems at lower BMI, particularly for women, is a sharp drop in bone density, which can severely affect mobility and overall health in later life. I suspect that correlation and causation may become muddied, with this issue. Though. After all, many skinny people get that way eating shite, too. if you live on tabs, instant coffee and toast, then you may have a BMI of 20, but you are likely to be malnourished.0 -
Getting an idea of what your lean body mass is (even if it's off by say 3%), you can get an ideal body weight if you know it and use this formula.
Your lean body mass divided by (1 minus the body fat percentage you want to be)
So say you're 120lbs lean body mass and want to be 20% body fat. Then apply the formula.
120/(1-.20)
120/.80= 150lbs
So 150lbs would be the target weight (approximate) to be at 20% body fat.
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This is misleading, generally when you lose weight you lose some lean body mass as well as fat. The exact proportion will depend on how you are eating, whether you are doing weightlifting, and how quickly you drop the weight. But you are never going to be able to keep ALL of the lean body mass.2 -
MarkusDarwath wrote: »
And if you use the NBA as a sampling, you'd think the average height is 3 inches taller than it actually is.7 -
It seems to me that this discussion is missing some critical information about statistics and populations. We should go back to the definition of the Body Mass Index. I'm going to use the Centers for Disease Control (US government) definitions as a fairly acceptable and standard authority.Body Mass Index (BMI)
Body Mass Index (BMI) is a person's weight in kilograms divided by the square of height in meters. A high BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems but it is not diagnostic of the body fatness or health of an individual.
http://www.cdc.gov/healthyweight/assessing/bmi/index.htmlWhy is BMI used to measure overweight and obesity?
BMI can be used for population assessment of overweight and obesity. Because calculation requires only height and weight, it is inexpensive and easy to use for clinicians and for the general public. BMI can be used as a screening tool for body fatness but is not diagnostic.
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
There are two important gems in the above
1. BMI... is not diagnostic of the body fatness or health of an individual
2. BMI can be used for population assessment.
These two are actually related because BMI is developed as a population standard. What does that mean? It means that a lot of individual measurements (people's weights) can be looked at with statistical averages to describe the behavior of the group. However, any individual measurement (weight) may or may not fall in the statistical averages. Why is this important? It's important because in order to make correlations with health, statisticians have to invoke some rules (aka assumptions) such as the Central Limit Theorem. This actually obfuscates the underlying relationships with any individual measurement, although it makes population-based descriptions much simpler.
Healthy people of any given height will have a variety of weights that depend on their individual physiology and the fact that there is actually a range of % body fat that healthy people can have. It's not like a body has one exact percentage of fat at which that person is healthy, and anything over or under means they're ill or going to become ill as a result.
Things that determine an individual's weight
1. Body frame size and shape. Bigger frames fill in with more stuff. A person with wide shoulders and a long torso, for example, will have more mass filling in their body than another who has long legs but a shorter torso.
2. Musculature.
3. Body fat (which is also related to age and gender)
So basically, the data point "weight" at any given height is dependent on 3 different variables. That makes it a crude tool. Add to that, the BMI graph is a skew distribution, not normal distribution. It's got a fairly short tail at the low end because very low BMIs (a) are often caused by serious illness (or starvation) which frequently result in death, and (b) often lead to serious illness rapidly. On the other end, tail past the mean is much broader because (a) people can get pretty fat and (b) most fat-related illnesses are not imminently life-threatening so they can live while pretty fat for a long time.
It's also becoming increasingly apparent that not all body fat is the same.Maxematics wrote: »The only reason her body is more accepted is because a lot of her fat falls in places that are beneficial for her aesthetically by American standards. Had it all been at her stomach, she'd simply be dismissed as being overweight.
While Maxematics' comment is partially true (regarding aesthetics), from a health perspective, the distribution of weight is absolutely critical according to current understanding of fat. Visceral obesity is linked to much worse outcomes than storage of fat in the breasts, buttocks and thighs. It is specifically visceral obesity that is linked to diabetes, heart disease, and other things. The thing is, as people become more and more overweight, even if they're genetically predisposed to dump fat in areas far away from organs, they will start to accumulate fat around their organs. This is the origin of the discrepancy in health outcomes at various BMI levels between Asian populations and Northern European populations; more fat stored viscerally (abdominally) at lower weights.
Regarding that Lancet article, there was a very interesting observation there as well:At the opposite extreme, there was a substantially higher mortality not only among those in WHO's underweight category, but also in those with BMI 18·5 kg/m2 to <20 kg/m2, suggesting that in excessively lean adult populations underweight remains a cause for concern. We have no information about whether the BMI in underweight individuals was always low.
Di Angelantonio, Emanuele. "Body-mass index and all-cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents." (2016).
Something tells me that we're not going to see a cry for people to get their BMI above 20. Yet it's associated with just as much health risk as being between 27.5 - 30 BMI and a greater health risk than being between 25 - 27.5, according to that particular meta-analysis!
The Lancet published a critique that points to the need for caution when making policy decisions based on statistical analysis given known limitations in those analysis as well as the role of further study.Berrigan, David, Richard P. Troiano, and Barry I. Graubard. "BMI and mortality: the limits of epidemiological evidence." The Lancet (2016).
BMI is a crude reduction but the best tool we have which is generally accessible and inexpensive for looking at the relationship of weight and health. I haven't even gotten into the biggest problem with it, which is that it attempts to make the relationship of mass and volume follow a square relationship when they are cubic, leading to linearly increasing error in the metric itself as height increases (a problem which is probably messing up all sorts of statistical analysis on health in the first place).
I'm not rejecting its use, but noting that it has some very serious limitations and it should absolutely NOT be a gold standard on its own by which indivdiuals are judged to be healthy or unhealthy (much less a moral judgment point).9 -
Also I've been dying to share this. Because statistical distributions do not mean what people seem to think they mean. A LOT of people fall outside 1 standard deviation of the mean. A fair number fall outside two standard deviations. And in a world with 7.4 billion people, 14 million people fall outside 3 standard deviations. That's a lot of people!7 -
Also I've been dying to share this. Because statistical distributions do not mean what people seem to think they mean. A LOT of people fall outside 1 standard deviation of the mean. A fair number fall outside two standard deviations. And in a world with 7.4 billion people, 14 million people fall outside 3 standard deviations. That's a lot of people!
14M is .2% of 7.4B or 2 out of 1000 people. 14M is a lot of people but pretty insignificant when taken as a part of the world's population.3 -
Packerjohn wrote: »14M is .2% of 7.4B or 2 out of 1000 people. 14M is a lot of people but pretty insignificant when taken as a part of the world's population.
It's approximately the population of Norway and Sweden combined. Yet people meet folks from those countries all the time! It's utterly amazing.
Also, 3 standard deviations would be 0.3% or 22.2 million... An even greater number! I changed my math when I was confused by my own graphic /facepalm.
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3 out of 1000 people on average, yes. How many selfproclaimed outliers have we had in this thread? About 10% of the people who posted I'd guess without counting.6
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@stevencloser this thread is not a random population sample.2
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Packerjohn wrote: »14M is .2% of 7.4B or 2 out of 1000 people. 14M is a lot of people but pretty insignificant when taken as a part of the world's population.
It's approximately the population of Norway and Sweden combined. Yet people meet folks from those countries all the time! It's utterly amazing.
Also, 3 standard deviations would be 0.3% or 22.2 million... An even greater number! I changed my math when I was confused by my own graphic /facepalm.
Maybe in your world people meet residents of Norway and Sweden, how about the billions of people in China, India South America and Africa (outside of those in the higher end areas of some of the major cities)?
3 out 1000 as outliers is not a big deal.0 -
@packerjohn you are missing the point entirely.1
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@packerjohn you are missing the point entirely.
I would disagree and suggest you are missing the point. BMI is a very reasonable starting point for the vast majority of the population in determining a healthy weight range. Understand there are outliers, but they represent a small number compared to the total population, hence the term outlier.
A 275 pound 5'5" individual wants to lose weight. Don't you think the BMI calculation will provide them with a reasonable range to shoot for in the vast majority of cases? If you don't think it is what, that is widely available at low cost, would be better? Do you think it would yield a significantly different result than BMI for most people?0 -
I think, enabling the thinking of "Oh I must be one of those outliers" by making it sound more common than it is is not good for the health of the population.11
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stevencloser wrote: »I think, enabling the thinking of "Oh I must be one of those outliers" by making it sound more common than it is is not good for the health of the population.
Did anyone even read my last paragraph?0 -
I'm not rejecting its use, but noting that it has some very serious limitations and it should absolutely NOT be a gold standard on its own by which indivdiuals are judged to be healthy or unhealthy (much less a moral judgment point).
Yes, I did read your last paragraph. I followed along and for the most part agreed with your entire post, I'm just pointing out that again- this is exactly the point many of us are making in this thread. Nobody here said it should be a gold standard or wasn't without its serious limitations. You make lots of good statements.
Also I've been dying to share this. Because statistical distributions do not mean what people seem to think they mean. A LOT of people fall outside 1 standard deviation of the mean. A fair number fall outside two standard deviations. And in a world with 7.4 billion people, 14 million people fall outside 3 standard deviations. That's a lot of people!
This is where I lost you a bit. I don't think anyone here was discussing statistical distributions in the sense you are. Otherwise, I wouldn't be using term "outlier"- as outliers don't technically exist when we're talking distribution curves.
What are you representing with that normal distribution curve? While the basic principles of distribution curves and standard deviations are not going to change, the subject matter and what you're applying it to certainly does. You're using the entire world's population as a data set. Were you talking about what weight/BMI/BF%/whatever the world population currently is? In that case I think we've established that being too many standard deviations away from the mean is not a good thing, and there's also the assumption that the average is healthy to begin with. Are we talking about BMI's ability to predict health in a population where everyone is healthy (employing Central Limit Theorem)? In that case saying BMI does not apply to 14-20 million people is being misleading because you were assuming an entirely healthy population to begin with (along with a ton of other assumptions). Statistics are great but they can't be used in a vacuum without labels and definition- the clinical application is incredibly essential to consider as well.
Your discussion of statistical distributions isn't what bothered me- it's the blanket-statement message you were sending at the end there without defining what you were showing, which makes me inclined to agree with this:stevencloser wrote: »I think, enabling the thinking of "Oh I must be one of those outliers" by making it sound more common than it is is not good for the health of the population.4 -
Packerjohn wrote: »
I would disagree and suggest you are missing the point. BMI is a very reasonable starting point for the vast majority of the population in determining a healthy weight range. Understand there are outliers, but they represent a small number compared to the total population, hence the term outlier.
Unless that "vast majority" are only those within one standard deviation of mean, in which case your "vast majority" is just over 68%. Yes, that is still a sizeable majority, but if the metric is less than reliable for 32% of the populace then it absolutely should not be used as a standard go-to.
No method should become a default for assessing individual health unless it is reasonably reliable for at least 95% of people, preferably more.A 275 pound 5'5" individual wants to lose weight. Don't you think the BMI calculation will provide them with a reasonable range to shoot for in the vast majority of cases? If you don't think it is what, that is widely available at low cost, would be better? Do you think it would yield a significantly different result than BMI for most people?
At best, a BMI calculation would tell that person they are likely at high risk for metabolic issues. Chances are at that size, they already know this.
Simply looking at their height on a BMI chart and saying, "you should weigh this much" is not terribly helpful if there's no reference to body composition. Even if the weight on the chart is appropriate for that individual, setting such a distant goal for the severely obese is likely to be a motivation killer.
Any means of actually measuring body fat, even if it's not the most exacting, will give a good indication of where the person is starting from and can be broken down into a range of shorter and longer term goals that are specific to that individual and their particular health needs.
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I honestly don't get this discussion. BMI is a good enough range for most people, there are outliers (and being a bit higher than the range isn't going to matter much anyway), but you should be able to figure out if you are (and take a reliable BF% test like the DEXA or employ waist ratio type measures if looking at yourself/photos isn't enough for you).
If you are way overweight, BMI serves as a decent starting goal if you want one and don't have one (I used my favorite adult weight which happens to be BMI 21, but BMI had nothing to do with me picking it). You will probably adjust at some point anyway, and you don't need a goal -- if significantly overweight you certainly know you are overweight. Claiming that some bad and inaccurate estimate of BF% NOW (when you will lose muscle probably anyway) is better than BMI for an unnecessary goal weight makes no sense.7 -
MarkusDarwath wrote: »Packerjohn wrote: »
I would disagree and suggest you are missing the point. BMI is a very reasonable starting point for the vast majority of the population in determining a healthy weight range. Understand there are outliers, but they represent a small number compared to the total population, hence the term outlier.
Unless that "vast majority" are only those within one standard deviation of mean, in which case your "vast majority" is just over 68%. Yes, that is still a sizeable majority, but if the metric is less than reliable for 32% of the populace then it absolutely should not be used as a standard go-to.
No method should become a default for assessing individual health unless it is reasonably reliable for at least 95% of people, preferably more.A 275 pound 5'5" individual wants to lose weight. Don't you think the BMI calculation will provide them with a reasonable range to shoot for in the vast majority of cases? If you don't think it is what, that is widely available at low cost, would be better? Do you think it would yield a significantly different result than BMI for most people?
At best, a BMI calculation would tell that person they are likely at high risk for metabolic issues. Chances are at that size, they already know this.
Simply looking at their height on a BMI chart and saying, "you should weigh this much" is not terribly helpful if there's no reference to body composition. Even if the weight on the chart is appropriate for that individual, setting such a distant goal for the severely obese is likely to be a motivation killer.
Any means of actually measuring body fat, even if it's not the most exacting, will give a good indication of where the person is starting from and can be broken down into a range of shorter and longer term goals that are specific to that individual and their particular health needs.
Unless that person is unusually muscular a bodyfat% goal or BMI goal will result in a goal in pounds that is very similar
As far as goal setting, depending on the individual a health care provider could give a series of step goals to get to the final to prevent giving up/burnout.
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Unless the method you are using is actually less accurate than BMI
http://weightology.net/weightologyweekly/index.php/free-content/free-content/volume-1-issue-4-the-pitfalls-of-body-fat-measurement-parts-3-and-4-bod-pod-and-bioelectrical-impedance-bia/the-pitfalls-of-bodyfat-measurement-part-4-bioelectrical-impedance-bia/
The article you linked does not support the idea that BIA is less accurate than BMI, except that in some cases it doesn't accurately show trends in fat loss. BMI, as several have pointed out, is not even a measure of body fat, so it really can't even be compared as a means of determining body composition.0 -
Packerjohn wrote: »Unless that person is unusually muscular a bodyfat% goal or BMI goal will result in a goal in pounds that is very similar
I am not unusually muscular, yet I have mathematically demonstrated more than once that a better-than-average BF goal of 15% still puts me well above the very lower limit of "overweight" for my height according to BMI.
I do have broad shoulders and a disproportionately long torso (that latter is a factor I had overlooked), but if that is enough in itself to qualify me as "unusually muscular" then there is a lot greater percentage of such folks in the general population than BMI defenders are admitting to.
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MarkusDarwath wrote: »Packerjohn wrote: »Unless that person is unusually muscular a bodyfat% goal or BMI goal will result in a goal in pounds that is very similar
I am not unusually muscular, yet I have mathematically demonstrated more than once that a better-than-average BF goal of 15% still puts me well above the very lower limit of "overweight" for my height according to BMI.
I do have broad shoulders and a disproportionately long torso (that latter is a factor I had overlooked), but if that is enough in itself to qualify me as "unusually muscular" then there is a lot greater percentage of such folks in the general population than BMI defenders are admitting to.
You are basing your claim on measurements taken by a notoriously inaccurate device and assuming your muscle mass will be the same when you reach goal.
I'm not exactly convinced.
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3dogsrunning wrote: »You are basing your claim on measurements taken by a notoriously inaccurate device and assuming your muscle mass will be the same when you reach goal.
I'm not exactly convinced.
And BMI defenders base their claims on appeal to authority. That's not exactly convincing either.
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Let me clarify then. The BMI vs health is charted on a normal probability distribution. The confidence intervals in most correlation studies suggest only 1 standard dviation is taken into account, sometimes 2 and never 3 because bmi is being used as a proxy for visceral fat. So a lot of folks get labeled as "at risk" by bmi who aren't carrying dangerous levels of visceral fast. A pretty large number get "healthy" labels so carry visceral fat because of the BMI proxy as well. However, BMI is cheap and statistically not much different in predictive results than body fat analysis, largely because most analysis methods also cannot distinguish between visceral and subcutaneous adiposity.
Ultimately, a person's metabolic health as tracked by blood sugar, cholesterol, blood pressure, heart strength (stress test) and blood chemistry are far more important for an individual. Weight gives a crude estimate of body fat that can be tracked over time on an individual.
Personally, I think the most important thing is functional ability. Can you do the things you want to do? Is your weight impacting your life personally, if you're fully honest? We don't all have to be marathon runners or heavy lifters or have the physique of a professional athletes to be healthy.
I've tried very hard to stay away from the personal in this discussion , so accusing me of being an "enabler" stings. Yet I will confirm that as I understand it, the science behind dropping "healthy" to a BMI of 25 from 27.5 was spurious at best. The health outcomes of individuals between 25 - 27.5 ON AVERAGE are better than those between 18.5 - 20.
The statistics just don't bear out the antipathy towards overweight status that several posters have demonstrated. In particular, one person with a very low BMI attacked even people within the normal range for being too fat, but statistically, by the study cited, that person is at greater risk than others between 25-30! Yet no sane person is going to suggest we raise the minimum acceptable BMI, and drawing any conclusion about that person's health would be the venture of fools.
There has been a lot of creep about aesthetics in this thread, which is terrible when discussing health policy because aesthetics change by time and culture.4 -
I love when people acknowledge that their info source is full of bunk. Except, of course, the one bit that they agree with.
Cherry picking, at its finest.2 -
MarkusDarwath wrote: »Packerjohn wrote: »Unless that person is unusually muscular a bodyfat% goal or BMI goal will result in a goal in pounds that is very similar
I am not unusually muscular, yet I have mathematically demonstrated more than once that a better-than-average BF goal of 15% still puts me well above the very lower limit of "overweight" for my height according to BMI.
I do have broad shoulders and a disproportionately long torso (that latter is a factor I had overlooked), but if that is enough in itself to qualify me as "unusually muscular" then there is a lot greater percentage of such folks in the general population than BMI defenders are admitting to.
If your waist at the navel is 47inches as you said you are pushing 40%+ in bodyfat currently. Not 34-35%. You have to be honest with yourself man. I spent a number of years telling myself I was an outlier too...
http://www.builtlean.com/2012/09/24/body-fat-percentage-men-women/
I was reading up on anabolic roids for a different thread and found this interesting read by a natural bodybuilder.
http://www.muscleforlife.com/side-effects-of-steroids/
This is a ripped dude 6'2 188 lbs at 7%BF. HE has 174lbs of lean mass. He is near the peak percentile of natural muscle. At 15%BF he would be 205ish lbs. He has a case where at 205lbs the BMI chart doesn't quite fit him, but only by 1 point is he into "overweight".10 -
MarkusDarwath wrote: »Packerjohn wrote: »Unless that person is unusually muscular a bodyfat% goal or BMI goal will result in a goal in pounds that is very similar
I am not unusually muscular, yet I have mathematically demonstrated more than once that a better-than-average BF goal of 15% still puts me well above the very lower limit of "overweight" for my height according to BMI.
I do have broad shoulders and a disproportionately long torso (that latter is a factor I had overlooked), but if that is enough in itself to qualify me as "unusually muscular" then there is a lot greater percentage of such folks in the general population than BMI defenders are admitting to.
Have you been lifting weights for a long time? If not, the ideal of a man in his mid 40' getting to 15% bodyfat at your height and 220 pounds most likely will not happen.
15% BF is in the range for college baseball players, who have most likely been playing other sports recently in hs and are usually on a structured lifting program. Not to mention naturally high testosterone levels. Given your current size you may want to get your levels checked. It will be hard enough trying to get to 15% bodyfat at the weight you're looking at let alone with low levels
http://www.ncaa.org/health-and-safety/sport-science-institute/body-composition-what-are-athletes-made
Again, best of luck but you've picked some pretty challenging goals1
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