BMI

Question
I've heard that a lot of people deemed obese are still considered medically healthy. At what point does BMI matter? When is a person overweight enough that they actually are unhealthy with no way around it?

Answer
Hi James -

I'm going to start with BMI - it's a useful tool when we study populations, but it doesn't tell us how healthy an individual is. Actual fatness (percent fat relative to lean body mass) is better and more closely tied to individual health outcomes. Even better is something like the Edmonton Obesity Staging Scale which is designed to evaluated the impact of weight on multiple aspects of health. We use BMI because it's easy, but in the long run it not the ideal tool.

That said, it's pretty hard to have a very high body weight and not have poorer health as weight goes up. Not that it does not happen, but it's more the exception than the rule. Not only is obesity tied to many chronic diseases but it's also generally associated with shorter lifespan. If our ideal in health is both quality of life and longevity, obesity tends to reduce both.

I hope this helps. It's not at all an easy or straight forward question!

In Health,

Dr Jacques

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