this post was submitted on 08 Apr 2024
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BMI isn't science. Its an almost 200 year old equation that was arbitrarily fitted to data. There is no go reason square ones height except that it fit the data. The cutoffs are arbitrary and, at least in the US, shifted in 1997.
And there is a growing body of evidence showing it's not accurate for many cases in addition to the one you provided.
We have better indirect measure and far better direct measures for assessing disease progression and likelihood of disease development. Getting rid of BMI won't stop fat shaming, but I hope it gives people pause.
I completely agree, we need to move on from BMI. But it's a bit silly to say it's BMI isn't science when it's been used for the entirety of modern health sciences. People would be shocked by how many crude, yet useful enough measures that health sciences use even today. And it's notoriously slow/stubborn in adopting the best tools for many methods. Still, humanity has continued to make scientific progress with them.
Show me the science in the particulars and I'm happy to change my mind. Its widespread use in the modern medical system doesn't make it scientific. We continue to use generally true ideas such as drink water and then wrench them into prescriptive positions like drink 8 cups of water per day. Literally no science to support that claim.
What science would change your mind? There's never going to be a magical cutoff number for cholesterol or height or weight that separates healthy and not healthy.
Heuristics are useful tools and sometimes that's the best you get. You need water to live, clogged arteries cause heart attacks, insulin resistance leads to diabetes. Exactly how much of any given thing causes bad outcomes is going to vary case by case, but doesn't negate trends.
I say all this as a former wannabe body builder who hasn't had a BMI under 25 in about 20 years, but I still know a BMI of 60 or 80 is no good.
I though I was clear about this, but I'll reiterate.
A better alternative, as I had previously linked to, would be abdominal fat as measured at the waist. Easy heuristic and closely correlated to CVD.
All of what you say is true, but you're not address my particular issues.
Thx sorry I didn't read all your comments in the post, I was using that question as a proxy to whether or not your discussion was in good faith. It seems like the answer is yes.
I frequently wonder how many better metrics are available that just aren't as easy to capture as stepping on the scale, grabbing blood oxygen, and taking blood pressure. I'm sure that part of the balance is value of vitals versus time or effort to collect them.