Jose Pasindo

Professor Sotirakopulos
English 1102 HON 01
20161212

Body Mass Index and Modern Obesity Status

During an initial visit with a primary care physician, there are forms, questions and
standard measurements that medical professionals track for every patient. Your medical history,
medication, allergies, what hurts, or what are you are looking to be seen for. All are questions
that one might receive with any medical professional. Now imagine instead of visiting the doctor
at the office, what if you could simply take an efficient 15 minute survey from home.
Standardized questioning gives a general idea of what is going on, and this could save you time
from having to travel to an appointment co-pays, or lab fees. Well now, what if the results of the
survey told you that you are 70.7% at risk for a life altering condition? Would you trust the
results and go on with your day, or would you want to have more a little more information? In
2015, the Center for Disease Control and Prevention released a report of 2014, 37.9% of the
adult population was obese, and 70.7% of American adults were categorized as overweight or
obese. Being overweight or obese is associated with various health conditions including coronary
heart disease, strokes, cancers and/or even death. On a personal level, individuals who are
categorized overweight or obese face our culture live with fat jokes and criticism of weak
characters. Quite literally being categorized overweight or obese can alter our lives physically
and/or mentally.
Body mass index is used by the modern medical to diagnosis obesity in America. Since
1998, the National Institute of Health standardized the use of the Body Mass Index Chart to

identify and evaluate obesity (NIHLBI). Body Mass index originated in the 19th century and was
formulated by a mathematician by the name of Lambert Quetelet (1796-1874). It was meant to
help identify someone who is at risk of developing a medical condition. BMI uses an individuals
weight in Kilograms divided by height in meters squared. Another equation for BMI is, weigh in
pounds times 703 all over height in inches squared. The resulting number is your rating or
level/degree of fatness. The Normal weight body mass index ranges from 18.5- 24.9, overweight
ranges from 25-29.9, and obese weight is rated at 30.1 or above. The body mass index is then
placed on a scale from 1 to 100 and in turn it is used to estimate the risk for disease or health
issues. It is the least expensive method currently used in indicating health risk and thus allows us
to amplify our statistics to larger population groups simultaneously
In 2013 the American Health Association officially diagnosed obesity as a disease. This
decision was a good or a bad thing depending on an individuals health. It was a good for those
would were pleading for the switch to medical ailment from cosmetic procedure. Individuals
struggling with weight issues were then able to apply for health claims, counseling or
medications on their insurance plans. Multiple factors need to be assessed in order to figure out
exactly how or why we become overweight, but since the turn of the century, the condition of
excessive body fat mass is identified and diagnosed by an estimation. Just as in the idea of taking
our hypothetical survey, the body mass index is too rigid, and does not take into account
variables. Variations in age, gender, ethnicity or location of adipose tissue are not considers for
modern body mass index. To add on to the fact that it was created in the 19th century, body mass
index was only meant to be a quick estimation for the degree of fatness (Devlin). The important
difference between a survey and a visit with a medical professional is in the interpretation. The

reason that we go to medical professionals in the first place is for their expertise and insight into
health and disease.
70.7 % might seem shocking but if those statistics are a result of a faulty premise, the
conclusion with be faulty. Tim Hatton and associates collected the data from hundreds of
thousands of men from the 19th century and published their findings in the Oxford Economic
Papers. They concluded that between the years 1871-1875, the average male height was 55,
and 1971-1975 the average was 510(Hatton). With the passing of time, we are growing in size
because of technological advancements, and living without fear of famine. Body Mass Index
does not directly correlate with health. According to Tomiyama and associates, millions of
American are being misdiagnosed with a higher health risks who could otherwise be healthy.
Their study analyzed patient information from the 2005-2012 National Health and Nutrition
Examination Survey to compare metabolic health versus the findings of the Body Mass Index.
Using blood pressure, triglyceride, cholesterol, glucose, insulin resistance and c-reactive protein
data, population frequencies/percentages of metabolically healthy versus unhealthy individuals
were stratified by BMI (Tomiyama at el). The study found that more than half of the overweight
individuals, 29% of obese, and 16% of higher obese ranges were actually metabolically healthy.
The highlight was that 30% of normal weight individuals analyzed turned out to be metabolically
unhealthy. BMI fails to disseminate what other types of tissues are being calculated, or if the
adipose tissue is internal or external, bone density, muscle mass, or water weight. All are
important indicators that are not currently considered in assessing obesity. Also, we as human
beings, as a species, are constantly growing, living longer, and staying healthier.
Overall BMI is good at what it was meant to be. An indicator to dig deeper into a
persons health, but as a standard seems unsound. You do not have to look far in national sports

for an ideal example of how body mass index fails in interpretation. The National Football
League recruits the biggest, strongest, fastest and healthiest athletes from around the country to
compete at the professional level. The NFL combine is a competition containing six main athletic
events to test college athletes wishing to go pro. From the National Football Leagues Combine
website, I collected the Body Mass Indexes of the top 10 in each event and found that only two
athletes were in the normal weight status, 43 were overweight, and 14 were obese. 95% of the
top performers were overweight or obese. Some of the fetes that are performed during the
Combine far exceed what would be considered normal fitness. Christain Westerman performed
34 repetitions in the 225 pound bench press test. At 63 and 298 pounds Westerman is
categorized as severely obese with a 37.2 BMI. One of the overall highlights of the combine is
the 40 yard dash. Keith Marshall was the most explosive runner, and the top performer in the 40
yard dash. With a BMI of 30.5 he moved his frame across the finish line, start to end, in a time of
4.31.
There are many other alternatives to BMI that would be easy for doctors to use which
correlate to body fat percentage. In the case of testing for the true body composition of an
individual, Dual energy X-ray absorptiometry is the gold standard in finding the densities of
different tissues in human beings. The procedure calls for a patient to lay face up on a table as
the machinery scans x-rays though-out the body. Some might by scared of the radiation, but the
dosage is only half of the amount as a flight across the country (Roche). For those who worry
more about the implementation, there are other feasible, inexpensive, alternatives that would
only require medical professional to minimal equipment or training. The Smart Body Mass Index
is a variation of BMI but it also accounts for the age range and factors recommended body fat
percentages. Skin caliper measurements comes in a 3-point, 4-point, and 7-point tests which uses

different specified locations on the body to calculate the percentage of body fat. Doctors and
other medical professionals could seek continued education and calipers cost anywhere from 10300 dollars depending on the brand. Another alternative is bioelectrical impedance. It sends a
low energy impulse through the body to measure different densities of water, body fat, bone, and
muscle. With a combination of techniques there can be a more accurate assessment for
identifying health risk.
Obesity is too complex for one number to define someone as unhealthy when they have
excess weight. There needs to be a specialized standard for identifying and evaluating obesity
considering various methods. We should analyze our standards at the same severity as the
diseases they are supposed to diagnosis. Mis-categorizing individuals as overweight or obese has
the potential to trap them in a certain way of thinking. The single number to keep baring on their
conscience, holding them in a single mindset. With Body Mass Index as the standard, we might
never find a way to change the obesity epidemic. With more information to work with
individuals will start to ask more questions and find answers. I might not a physician or a
medical professional, but I can deduce the facts that BMI should not be a standard of diagnosis
for modern obesity status. Measurement for the identification of obesity should be treated on the
same vein as measurement for blood test. I propose having patients take their body composition
test under the same metabolic conditions, around the same time of the day, and as close to the
same level of hydration for every test. The one thing I am proposing that there needs to be a new
standard, so one day we can take a more scientific approach to the spread of obesity in America.

Work Cited
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