Your weight is just a number on the scale and – as it turns out – that number may not be as damning to your health risk as once feared.
We’re talking about that clunky equation that determines your Body Mass Index, or BMI. Some health experts have maintained that the BMI has its limits and that this ratio may not be the best predictor of health risk associated with your weight.
There is a more sensitive and comprehensive assessment test that can help you and your healthcare provider understand better how your weight may be impacting your health. And for that we owe a tip of the hat to our friends to the north.
The experts who’ve weighed in on this important subject are declaring the Edmonton Obesity Staging System (EOSS) a more comprehensive and accurate way for clinicians to talk to their patients about their risk for diseases associated with their weight.
For those of you who’ve been stung by the shame of a large BMI, the weight has been lifted a bit, eh?
The EOSS says that to assess a person the clinician will be better served using both Obesity Class (BMI) and the Obesity Stage. Obesity Class (1-3) is based on BMI, and is a measure of how “big” someone is. (Obesity Class 1 = 30-34.9; Class 2 = 35 – 39.9; Class 3 = >40). The Obesity Stage (0-4) is based on the Medical, Mental, and Functional impact of obesity and is a measure of how healthy the person is. A clinician will use the “4Ms” framework to assess mental, mechanical, metabolic and monetaryobesity drivers.
It is now well established that EOSS is a far better predictor of obesity related mortality risk than BMI or weight circumference alone. It also provides an important framework for both the patient and the clinician to target treatment.
It’s now deemed possible to be overweight but not at risk. Undertaking lifestyle change – and we don’t simply mean changes to your diet – can help lower your risk so you can enjoy a healthier, longer life.
The EOSS could prove to be the best import since hockey, beer and Canadian bacon!
SCALING BACK THE BMI
The BMI is a ratio of weight to height, and represents an estimation of your body fat. Over time it has come to be used to assess risk for diseases associated with weight. A number ranging between 18.5 and 25 translates to an optimal weight. Over 25 is considered overweight, while over 30 quantifies you as obese. A BMI below 18.5 is considered underweight, and may indicate health risk as well.
To determine your BMI, click here and use this online tool.
BMI is used to classify kids, too. But this formula is slightly different than the one used for adults. While the same formula is used, the number is then compared to other kids of the same sex and age. (More information on assessing a child’s weight can be found here.)
The BMI is not a diagnostic tool; it’s a starting point that can raise a red flag and call attention to a possible health risk from extra weight. Obesity-related illness is a big problem in America where more than 30% of our kids are overweight and therefore at risk for diseases formerly seen only in adults. This includes type 2 diabetes and high blood pressure.
BMI is easy to use – you just need a height and weight to decipher your rate. As a general screening tool, it’s fine – to a point.
It is never used to assess elderly or pregnant women, but the biggest criticism of BMI is that it may overestimate body fat in muscular people. Take former California governor, action hero actor and bodybuilder Arnold Schwarzenegger. Arnie stands about 6-foot-2 and 240 pounds. That gives him a BMI of 30.2 – a number that would indicate the Terminator is obese and therefore at risk of being terminated by his weight.
But a dire diagnosis based solely on the numbers would be off base in a case like this.
So, hasta la vista, BMI. It’s where you carry your weight that counts. If most of your fat is around your waist (abdominal obesity) rather than your hips you’re at increased risk for heart disease, type 2 diabetes, and all-cause mortality. Research shows that over the past 15 years 50% of American adults are classified with abdominal obesity.
The optimal waist measurement for women is 35 inches or less; for men, it’s 40 inches or less but these numbers vary by race.
The National Institute of Health says that when considering health risk, BMI needs to be considered along with other health issues which, if you have three or more, is called metabolic syndrome: abdominal obesity, high blood pressure, high “bad” LDL cholesterol or low “good” HDL cholesterol, high triglycerides, and high blood glucose. A family history of premature heart disease, physical inactivity and smoking combined with overweight, increases your risk for heart disease and other conditions.
Susan Burke March is a registered and licensed dietitian, nutritionist and certified diabetes educator. As our eDiets Chief Nutritionist, she promotes the dietary health and wellbeing of consumers worldwide.