Oct 13, 2023 23:00:00

BMI, which is calculated based only on height and weight, is not suitable for indicating obesity, so how should it be used to indicate obesity?

Body mass index (BMI), which is calculated by dividing body weight by the square of height, is a body mass index that indicates the degree of obesity of a person, and it is thought that the higher the number, the higher the risk of diabetes, hypertension, cerebrovascular disease, etc. I am. However, it has been pointed out that BMI 'does not include the amount of body fat in its calculations, and ignores various factors that affect health, such as age, gender, and race.' Mr. Stanford recommends introducing a new system to replace BMI, the Edmonton Obesity Staging System (EOSS).

Why BMI is flavored — and how to redefine obesity
https://www.nature.com/articles/d41586-023-03143-x

To calculate your BMI, measure your weight in kg and divide your weight by your height in meters squared. For example, the BMI of a person with a weight of 70 kg and a height of 1.7 m is 70 ÷ (1.7 x 1.7) = 24.22...

Furthermore, BMI is classified into the following four categories according to the degree of obesity. The BMI of a person with a weight of 70 kg and a height of 1.7 m is approximately 24.22, so the following categories fall under 'normal'.

・BMI less than 18.5...low weight
・BMI between 18.5 and 24.9……normal
・BMI between 25.0 and 29.9...Overweight
・BMI is 30.0 or more...Obesity

BMI has been used as an international standard for indicating a healthy weight for decades. A high BMI is said to increase the risk of heart disease, liver disease, arthritis, cancer, etc.

On the other hand, the risk of heart disease and cancer is thought to be increased not only by BMI, but also by factors such as ``

sleep time '' and `` excessive intake of vitamin C, etc. '' Additionally, the risk of developing a disease varies greatly depending on various factors such as age, gender, and race. It has been pointed out that the BMI calculation does not take into account these factors and is inappropriate for calculating accurate results. Additionally, BMI does not take into account the amount of body fat such as subcutaneous fat, visceral fat, and fatty liver.

Fatima Stanford of Harvard Medical School says, ``Indicators that calculate only height and weight, such as BMI, do not tell us anything about an individual's health status.''

In fact,

a study published in July 2023 by Aayush Visaria of Rutgers University and colleagues found that the risk of death for adults whose BMI falls under the category of 'obese' is the same as that of adults who are considered 'normal.' It has been reported that the extent of Additionally, a study by Janet Tomiyama, a professor of health psychology at the University of California, Los Angeles, and colleagues found that approximately 30% of subjects who were classified as obese based on BMI had normal blood pressure and cholesterol levels. , it was revealed that there was little difference in the cardiometabolic health status of obese and normal subjects.

Additionally, even with the same BMI, older adults tend to have less muscle and more body fat than young adults, and while men tend to accumulate fat mainly in their abdomens, women tend to accumulate fat in their buttocks, hips, and thighs. Women tend to have more body fat than men even with the same BMI, and it has been shown that women have a lower risk of dying. Furthermore, because BMI was developed using measurements of white people, it has been pointed out that blacks, yellow people, etc. have different body compositions and fat locations, so it may not be possible to properly diagnose them using BMI. I am.

In response to these studies, starting in June 2023, the American Medical Association (AMA) will recognize that the diagnosis and treatment of obesity using BMI is incomplete, and will begin using various indicators including BMI when making diagnoses. It

expresses that.

In response to the current situation where BMI cannot provide appropriate diagnosis and treatment, various studies have been carried out. A Stanford University research team has assembled a team of approximately 60 obesity experts to examine major organ systems in the body to better understand how weight affects health. I am. According to Stanford, the diagnostic criteria devised through the study will be announced in 2024.

Additionally, Germany-based medical director Alya Sharma says, ``BMI only tells us how fat the person who calculated the number is, not the risk of developing a disease.'' They developed a system called the Edmonton Obesity Staging System (EOSS) that measures physical, mental, and functional health status in addition to BMI. EOSS indicates health risks in five levels, and even if patients have the same BMI, the level indicated by EOSS will change depending on their level of anxiety regarding heart disease or obesity.

EOSS was incorporated into the 2020 Canadian clinical guidelines for obesity in adults, and in 2022, the assessment tool became commercially available in Chile and Ireland. 'Work on various indicators beyond BMI is just beginning,' said Stanford.