'Fat but fit' or 'skinny and sedentary'? |
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Dr. Kenneth Cooper Comments
on New Weight Guidelines
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Nearly 55 percent of the U.S. population is considered overweight according to a recently announced government guideline based on body mass index (BMI). That represents 97 million people who tip the scales at or above a BMI of 25. An estimated 29 million of that group were considered normal weight under earlier guidelines. The panel of 24 experts who wrote the new definitions on overweight and obesity did so on behalf of the National Heart, Lung and Blood Institute, which is part of the National Institutes of Health. These controversial new guidelines, which some health professionals think are extreme, will become the standard used by physicians to help determine when and if a patient is a candidate for the use of obesity drugs. |
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Kenneth H. Cooper, M.D., founder of The Cooper Aerobics Center, issued the following statement about the new BMI guidelines and the relationship between fatness, fitness, and weight. |
They are putting way too much emphasis on weight and not enough on fat. All the scientific studies I read show that it's fat, not weight, that relates to high blood pressure, adult onset diabetes, gallbladder disease, cancer, and various other health problems. If you limit your interpretation of obesity to the BMI, you may be making a major mistake.
Many patients I see in Dallas at the Cooper Clinic are muscular and lean as determined by underwater weighing and yet they have a high BMI. To use their BMI as a single standard for body weight and call them obese is inaccurate and an injustice to these healthy, athletic individuals.
A second point, the location of fat is just as important or more important than is the body weight. For example, excessive weight in your stomach is dangerous compared to fat that is primarily in the extremities. The waist-to-hip ratio is an important predictor of disease. The ratio should be under 0.85 for a man and 0.75 for a woman. Any ratio above 1.0, that is, the circumference of your waist is greater than the circumference of your hips, is very often associated with disease. The distribution of the body weight is very important.
And, there's a third point to consider. The Cooper Institute for Aerobics Research studies, as published in 1995 in The International Journal of Obesity by Barlow, Gibbons, Cole, and Blair, followed 25,000 men for over eight years. The study showed that men who were above 30 BMI but exercising enough to reach the top 40 percentile level of fitness, as measured by the time they were able to walk on the treadmill, had a considerably lower risk of dying from all causes-- heart attacks, strokes, diabetes, and death from cancers specifically-- than people who are normal weight (the study used under 27 BMI as normal) but totally sedentary, i.e. ranked in the bottom 20 percentile. The point, as made by our Director of Epidemiology Steve Blair in major newspapers and magazines, is that you are better off being fat and fit than skinny and sedentary. I talk about that as being the "two fs and the two ss".
This 25 BMI rule can be demoralizing, discouraging, and depressing, Many people feel "I have worked so hard to achieve a good body weight and yet now I am fat. I might as well give up." I have heard people make that statement verbatim several times. "I can't reach the goal that is realistic for me according to these standards." It is a disservice to these people to promote an attitude around this country that you must not exceed 25 BMI.
How to calculate BMI
The best way to get your BMI is to take your body weight in pounds, multiply it by 700, and divide it by your height in inches squared. That formula will give you almost exactly the same results as using the body weight in kilograms divided by the height in meters squared. Example: someone 5'8" and weighing 170 pounds is slightly into the overweight category with a BMI between 25 and 26. [170X700=119000 divided by 4,624 (68"X68") = 25 plus]
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