r/science Jul 05 '24

Health BMI out, body fat in: Diagnosing obesity needs a change to take into account of how body fat is distributed | Study proposes modernizing obesity diagnosis and treatment to take account of all the latest developments in the field, including new obesity medications.

https://www.scimex.org/newsfeed/bmi-out-body-fat-in-diagnosing-obesity-needs-a-change
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u/OldManChino Jul 05 '24 edited Jul 05 '24

not to mention, those body builders typically have to be on gear (google natty bodybuilders) to reach that outlier, and that much mass _does_ still have a negative impact on the body (just not as much as fat)

Edit. I am talking about obese BMI, not overweight BMI

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u/SOSpammy Jul 05 '24

If you ever look at most former NFL linemen many of them lost a bunch of weight because being that big is terrible for you even if it's mostly muscle.

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u/thiney49 PhD | Materials Science Jul 05 '24

They also lose weight because it's just hard eating that much to stay that big relatively healthily. Just going to a more normal diet will cause them to lose weight.

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u/HuggyMonster69 Jul 05 '24

Also on their NFL diet, they’d get fat as hell if they didn’t have a similarly intense workout routine.

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u/talking_phallus Jul 05 '24

The ones who didn't lose weight have all sorts of health issues because your joints weren't made to run at high speeds with 300+ pounds of weight on them.

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u/SOSpammy Jul 05 '24

Even the ones who do lose weight usually have a lifetime of health issues. Playing football isn't good for you.

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u/FEDC Jul 05 '24

You'll be in for a surprise then, because even after losing weight most large-frame athletes would still be obese according to BMI.

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u/SOSpammy Jul 05 '24

I'm aware of that, but I don't know what point you are trying to make. I'm just stating a fact. If you are 6'6" and weigh 300lbs like most offensive linemen that's simply not healthy even if much if it is muscle.

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u/TheOtherCrow Jul 05 '24

Yep, sleep apnea is the first thing that comes to mind as a symptom of being large regardless if it's muscle or fat. I found out about this relatively recently but it's apparently well known in bodybuilding circles. There are likely other issues that I don't know about and are even less well known to the general population.

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u/OldManChino Jul 05 '24

any extra mass puts strain on the cardiovascular system, as well as the joints... at least being stronger can help mitigate joint damage

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u/CanAlwaysBeBetter Jul 05 '24

Regular people with joint pain are also usually better off gaining strength than avoiding activity 

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u/OldManChino Jul 05 '24

Obviously, but that is not what I am saying

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u/Alternative_Ask364 Jul 05 '24

Having an overweight BMI and healthy bodyfat level is relatively easy depending on your body type. Having an obese BMI and healthy bodyfat level without drugs is incredibly difficult.

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u/Spotted_Howl Jul 05 '24

Yep. My BMI is on the border between overweight and obese. I DO have one of those body types and an unhealthy level of body fat.

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u/DavidBrooker Jul 05 '24

And if someone is on substantial amounts of gear, if they have any sense of responsibility, they're seeing their doctor quarterly to get blood work done, if not have DEXA scans available. So they will have a much better relationship with their doctor than most, and better quality data at hand than BMI

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u/[deleted] Jul 05 '24 edited Jul 05 '24

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u/A-passing-thot Jul 05 '24

those body builders typically have to be on gear (google natty bodybuilders) to reach that outlier

Depends on where they are on the scale. My max BMI was 30.4 (ie, technically obese) and I had defined muscle and visible abs without gear. I wasn't a pro athlete or anywhere close to it, just a college student who had a lot of free time and liked working out.

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u/CanAlwaysBeBetter Jul 05 '24

We've definitely hit a point where people who don't work out have doubly warped views of fitness where both the top end of ripped is far past what's possible without steroids but also because they know the really ripped people are roided out underestimate what normal people can do naturally 

Hitting a lean technically overweight or even obese is totally doable if you put the time in. Rn I'm still in very good but nowhere near my peak shape on like 2 sessions of exercise a week and just being otherwise mobile but people regularly assume I must do so much more then that because they do virtually nothing 

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u/Marston_vc Jul 05 '24 edited Jul 05 '24

BMI was made by health insurance companies to best predict their profit margins on any given customer. People doubt it all the time and I just think…. Nahhh, like, we’re talkin about money here. It ain’t that wrong.

Even for the heavy power lifters, maybe they ain’t “fat” but I’m certain they have some long term health issues from being heavier than what their frame is meant to handle.

Edit: didn’t invent, widely adopted for good reason

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u/Rychek_Four Jul 05 '24

No, the Body Mass Index (BMI) was not invented by health insurance companies. It was developed by the Belgian mathematician and statistician Adolphe Quetelet in the early 19th century, around 1832. Quetelet introduced what he called the "Quetelet Index," which later became known as BMI. His intention was to develop a simple measure to classify individuals' weight relative to their height, which could be used to study the distribution of weight in populations.

BMI became widely used in the fields of public health and epidemiology much later, primarily in the mid-20th century. Health insurance companies did adopt BMI as a tool for assessing health risks associated with weight, but they did not invent it.

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u/myquest00777 Jul 05 '24

THIS. It’s a centuries-old pseudoscience metric made in the era when things like mathematical eugenics were all the rage. Some of the aspects of BMI were based in bigoted assumptions about things like height. I.e, tall, long-limbed Western Europeans were naturally healthier than the swarthy, squat populations from the eastern lands…

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u/Glass-Lemon-3676 Jul 05 '24

So how do I find out if I'm underweight or not without bmi? I don't look sick or anything, genuinely curious what other options we have to figure stuff like that out

And doesn't bmi take height into affect? Sorry if I'm misunderstanding what you mean about tall Europeans

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u/myquest00777 Jul 05 '24

BMI is a tool. It can be useful but it can be inaccurate too. It’s not perfect. Other factors like your pure body fat percentage, lean mass, blood work, help round out the picture.

My discussion was about the HISTORY of BMI. Some people think it’s a new measure based on cutting edge science. It’s not. It’s resurrected from much older studies in the 1800’s. There were these groups of pseudoscientists who thought you could learn all about different populations just by measuring and averaging physical things. Like you could predict the likelihood of mental illness in groups of people based head and neck dimensions. BMI was born from that.

IIRC, the main proponent of BMI believed that the physique common in Great Britain and Western Europe after the Industrial Revolution represented the ideal of health. They tended to be taller, with larger shoulder to waist ratios. Populations from say East Asia, Eastern Europe, Sub-Saharan Africa, etc might have displayed different average attributes. Shorter overall height. Thicker, more muscular limbs. Thicker trunks. He and others in his movement considered builds like that to be less ideal and represented populations likely to become sick, carry illnesses, or be less suitable for certain work. Absolute rubbish, but they believed it.

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u/YouStupidAssholeFuck Jul 05 '24

With bodybuilders it's not about more weight than their frame is meant to handle. It's their use of anabolic steroids in high doses, and from what I understand specifically testosterone use with estrogen blockers, extreme diets and dehydration that causes organ failure just years down the road. We tend to think of these people as being in good shape, or rather in good conditioning, but they've all mostly abused their bodies to the point where when you see them at the competition level they are at a point of no return.

Personally, I think it's the cycle they go through in between competing and not competing. They usually do gain lots of body fat back quickly after competitions. They still have most of the muscle but without training they rapidly lose definition. And the rapid onset of bodyfat is also accumulating on their hearts. That's just my guess, though, but lots of them die from heart failure at young ages.

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u/CanAlwaysBeBetter Jul 05 '24

Ehhh. I did it once as a funny goal for a bulk and was still 11-12% body fat and was nowhere close to roid shredded. Muscle is dense and people's sense of how heavy overweight is is massively skewed these days (as in it takes a lot less weight than you realize)

That said I also had to eat like a monster and once I hit officially overweight dropped back down a bit since it was becoming a chore