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MCAT, GPA, and...BMI?!

Discussion in 'Medical Students - MD' started by Meltyman, Apr 24, 2007.

  1. Meltyman

    Meltyman 7" Member 2+ Year Member

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    My friend in med school is a bit rotund (actually, ball-shaped). He/she has had various problems throughout med school:

    1) During M2 pathology lab, he/she was unable to see into the multihead microscope eyepieces without standing up. The TA would be pointing out stuff and we would be looking into our eyepieces, but he/she would have stand with knees bent to look, often moving our table in the process. Also, the chairs would creak and bend under the strain

    2) During M3 OB and surgery, he/she was never able to see into the surgical field because his/her stomach protruded too far

    3) During IM, he/she would try to run to codes with us, but he/she would get really winded and flushed in his/her face. He/she would look ready to code themselves

    4) There is a pretty steep ramp on a hill outside our school. When he/she would walk down it, going faster and faster, I would think: one false move, and he/she will start rolling and flatten anyone in the way

    Now, he/she is looking to specialize. He/she finds it awkward to have to tell patients to exercise and lose weight, and even to stop smoking. Pathology, surgery, and OB are pretty much ruled out. He/she does not feel competitive enough to try radiology, and also balks at the sedentary lifestyle and at sitting in a dark room all day. Any ideas?

    Also, should med schools look into taking more such students? After all, the morbidly obese are really underrepresented in medicine - something like 1-2% of med students. Perhaps they can offer understanding for the 30% (roughly) of Americans who are morbidly obese; after all, African-Americans and Hispanics are given extra consideration to represent and serve 10-15% of the population. Obese kids need role models, too; they don't have firemen or NBA players to idolize. Also, should Obesity Medicine be a specialty? They could be experts on the care of the obese. Any thoughts?
     
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  3. Droopy Snoopy

    Droopy Snoopy 7+ Year Member

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    I have sympathies for your ambiguosly gendered rotund friend, but I think giving admissions preference to the morbidly obese is a terrible idea. We could debate the lifestyle vs. genetics thing all day, but for sure minorities don't have any choice in the matter of their skin tone, nor do they choose their socioeconomic status (which is what is theoretically given admissions preference outside of traditionally minority schools), so I don't think that's a valid comparison. Also, there's a semi-serious thread in preallo called "Would you eat a poop hot dog to get into med school?" You can't tell me a bunch of desperate premeds wouldn't screw up their bodies for life on the Super-Size-Me diet if it would increase their chances even a little.

    I don't see why you, er, your friend should restrict your specialty choice based on the protuberance of their stomach. Choose a specialty that you love and could be happy doing for 40+ years and adjust your diet and exercise regimen accordingly. We've had the credibility debate on here many times, and of course some people are not going to take a hypocritical doc seriously. I don't think that's the way it should be but it's reality, and if your "friend" thinks this would make him/her an ineffective physician and is unwilling or unable to alter their lifestyle then perhaps that would be a good reason to consider certain fields over others.

    An obesity medicine specialty is intriguing, but it's basically what IM has become now anyway. Take away the metabolic syndrome and you're basically left with geriatrics.
     
  4. dilated

    dilated Fought Law; Law Won 10+ Year Member

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    They're already pretty heavily discriminated against, I think. The couple fat people in my class are (I get the impression) way more qualified than the average person here. I'm guessing they had an extra hurdle to jump to get in.

    That's life. The good looking kids here seem dumber than average but their interviewers liked them more (there are plenty of studies on this). At least you can lose weight, there's no fixing a busted grill. :p
     
  5. indo

    indo Feed me a stray cat 7+ Year Member

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    liar
     
  6. menaniac

    menaniac Moxious! 2+ Year Member

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    I think you are completely right about there being more hurdles to jump in the admissions process. When I was interviewing at what will remain an unspecified school, the first thing my interviewer commented on was my age (I'm an older non-trad), which was immediately followed by "...but you look like you're in very good shape. I was afraid you'd be fat, and if that were the case I'd have to recuse myself from this interview. I just don't think fat people have the stamina or self-control to be good doctors." All I thought was wow! Even if this is what you think, why on Earth would you say it out loud to a prospective student? I didn't know if the interviewer was looking for a comment, but I was very surprised at the animosity displayed. I also felt very sorry for anyone who would be subjected to such harsh discrimination. I guess its to the interviewers credit that they would have refused the interview rather than just writing off the potential student. But really, the whole thing blew my mind.

    As for giving preference for obese students, I don't really think that's a good idea either. How about a little fairness, that's all.
     
  7. OncoCaP

    OncoCaP 2+ Year Member

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    Your friend should do what s/he is interested in and figure out a way to do it. Some fields might not be much fun for any number of reasons, but I'm sure your friend can find something that will work. I'm guessing maybe pediatrics would be worth looking into, but your friend needs to make up his/her own mind. What does your friend like and what are his/her talents?

    I'm not sure that we need to increase the number of obese applicants. Yes, they do suffer discrimination. However, as our population becomes more obese (are we at 30 or 40% now ??), the number of obese medical students and physicians will also increase. No extra effort required, in my opinion.
     
  8. Dakota

    Dakota Senior Member Physician 10+ Year Member

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    There are no obese people in my med school class. I always wondered at what stage in the process they were weeded out.
     
  9. Sunshine1025

    Sunshine1025 10+ Year Member

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    Is having a morbidly obese doctor like having a doctor that smokes?

    I understand there are the people who are obese genetically.. but one about the ones that aren't?

    Isn't being morbidly obese and not exercising/eatting right/etc just like smoking in the sense they both go against what medicine is "about"?

    Don't take that wrong.. just thoughts I was thinking about after reading a smoking doctors thread.
     
  10. tch001

    tch001 Senior Member 5+ Year Member

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    ahhh is that why some schools require pictures with the application? hmm
     
  11. triangles

    triangles Junior Member 2+ Year Member

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    stop eating, fatty!
     
  12. shantster

    shantster Eye protection! 10+ Year Member

    I never saw any on the interview process either, and since there's nowhere on the AMCAS to submit anything about weight and thus the admissions committee has no way of knowing about it until the interview process, I'm guessing that the lower percentage of them being in medical school and being doctors is more due to the lower percentage of them applying.
     
  13. dilated

    dilated Fought Law; Law Won 10+ Year Member

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    There's definitely bias at the interview stage. Actually, my one fat premed friend did much worse than one might have expected from scores/ECs and will be attending one of the lowest ranked schools in the country despite good numbers. Hmm.
     
  14. lilnoelle

    lilnoelle Moderator Emeritus 7+ Year Member

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    We have a few that are either obese or close. Plenty of us are overweight.
    None are morbidly obese. The majority of my class are at the correct weight though.
     
  15. Engin

    Engin Senior Member Classifieds Approved 10+ Year Member

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    Don't they give "free" food anyways to all interviewees? So what is the OP saying? Do those fat muthaf&*^rs want two free boxes now? I say well played fatty, well played. You can have my chocolate milk.
     
  16. naegleria brain

    naegleria brain 2+ Year Member

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    ive thought about this. i think its due to the fact that medical students tend to be younger (read, ~25). obesity takes time to develop. think, the men probably are about ~165 right now, which isnt too bad. however, gaining just ONE pound a year, in thirty years puts you at 200. Two pounds a year, which is more reasonable, puts you well over 200. now you start flirting with the obesity line.
     
  17. Doctor Bagel

    Doctor Bagel so cheap and juicy Moderator Emeritus 10+ Year Member

    I agree that that's a huge part of it. Most people really aren't heavy when they're young, but most people are heavy when they're 50. Of course, that's why menaniac's interviewer worried that she might be fat.

    But since people are getting bigger sooner and since there have always been a small subset of the population who are obese from childhood, there probably is some discrimination going on somewhere in the admissions process. I agree with the others that a lot of it is probably pre-application.
     
  18. barasch

    barasch Member 7+ Year Member

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    There are also very, very few hideously ugly people in medical school. Where are the hunchbacks? Where are those with wall-eye? The ugly are heinously discriminated against in all aspects of life.
     
  19. Yachtclub

    Yachtclub Best Advice: Bring Donuts 2+ Year Member

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    I wanna go where you are.......

    Actually, there's very few hideous people, but there seems to be no shortage of VERY average looking people with no sense of style. MSI is way too soon to start wearing God-forsaken Danskos everyday
     
  20. dilated

    dilated Fought Law; Law Won 10+ Year Member

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    I don't get it, why are people always going off on rants about these things? I've seen them and they're just like bland, solid black leather shoes with no decoration or anything. Why are they so offensively ugly to people?
     
  21. makshim

    makshim New Member 7+ Year Member

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    I think there are few obese people in med school because many obese people are too lazy to exercise, these same obese people will be too lazy to work hard to get in.
     
  22. Doctor Bagel

    Doctor Bagel so cheap and juicy Moderator Emeritus 10+ Year Member

    Wow, way to show off all the prevalent stereotypes about the obese there. Thanks for the well-reasoned post. :rolleyes:
     
  23. bsmcga0

    bsmcga0 Junior Member 10+ Year Member

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    the BMI sucks, I am 6'0, 205 pounds with 8% body fat. I was at the doctor a week ago and she told me I need to lose weight immediately and have another cholesterol test (my last one was a year ago and the results were excellent). all this while my shirt is off for my physical. when I asked if she was serious she wrote the note for my cholesterol test and left the room.
     
  24. makshim

    makshim New Member 7+ Year Member

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    So a third of the population just has bad genetics?:laugh: Yeah. It can't be that they sit in front of the television all day.:laugh:
     
  25. indo

    indo Feed me a stray cat 7+ Year Member

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    and?
     
  26. caffeine37

    caffeine37 Senior Member 7+ Year Member

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    i read an article that talked about a positive correlation between educational level and life expectancy (and also healthy weight, eating habits, etc). it's all about delayed gratification.
     
  27. Villin

    Villin 10+ Year Member

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    Indo...:idea: maybe bsmcga0 is saying because he has a lot more muscle than the average human his height. this leads to an elevated BMI even though he is probably healthier than 99% of fatass america.

    here's a calculation for you. there are bodybuilders who are 5'8" who weigh 230 lbs...what's their BMI? :thumbup:
     
  28. Doctor Bagel

    Doctor Bagel so cheap and juicy Moderator Emeritus 10+ Year Member

    I'm not saying anything about genetics. However, I know lots of pretty hard working people who are overweight -- in fact, they're usually overweight just because they work so hard and don't take time to take care of themselves. Fat people aren't bad workers and aren't too lazy to do well in school.
     
  29. MattD

    MattD Curmudgeon 7+ Year Member

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    I'd find another doctor, personally. Algorithms are great in a code, but if your doctor doesn't have enough clinical reasoning to realize that the ripped up bodybuilder doesn't have a body fat problem, she probably needs to go back to residency for a lil' bit. Lord forbid you come in with a problem that needs to be 'figured out'!
     
  30. Dr.D-man

    Dr.D-man 5+ Year Member

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    If that happened to me, I would find another doctor.
     
  31. Tired

    Tired Fading away 7+ Year Member

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    That's hilarious! I'll have to remember how "overworked" fat people are next time I go to Walmart and see them puttering around on the little scooter things. :laugh:

    Fat people are fat because they eat too many calories and don't exercise enough. It's not "genetic" (that's just stupid), and it's not because they're "too busy" to take care of themselves (if I can drag my ass to the gym 4x a week, anyone can). It's energy intake versus energy expenditure, simple as that.
     
  32. w a n g

    w a n g blarg 7+ Year Member

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    haha. just as astronauts cant be huge, certain medical fields have the same requirements. i think every profession or occupation needs its reqs fulfilled.
     
  33. browniegirl86

    browniegirl86 10+ Year Member

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    Same here. There are 3 or 4 who might have a BMI in the 25-30 range, but that's about it.

    Hmmmmm.

     
  34. jdh71

    jdh71 epiphany at nine thousand six hundred feet Physician 10+ Year Member

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    No genetic evidence for obesity? Reeeeeeally? Just one study . . . there are more - do your own search if your interested
    -----------------------------------------------------------

    Variant alleles of the D2 dopamine receptor gene and obesity

    Margaret R. Spitz M.D.1, , , Michelle A. Detry M.S.1, Patricia Pillow M.S.1, Yaohua Hu1, Christopher I. Amos Ph.D.1, Waun Ki Hong M.D.2 and Xifeng Wu Ph.D.3, 1

    Abstract

    The mesocorticolimbic dopaminergic reward pathways have a role in the neuromodulation of appetite. There are data supporting a role of allelic variants of the D2 dopamine receptor (DRD2) gene and the number of receptor binding sites in vulnerability to substance abuse and obesity. We recently demonstrated that the A1 and B1 genotypes are in linkage disequilibrium and predictive of smoking status. Previous studies have evaluated the relationship between obesity and A1 but not B1 genotypes. Our objective was to assess the relationships between obesity and DRD2 TaqI A and TaqI B genotypes in healthy individuals. Subjects were 139 Caucasian average weight and 37 obese individuals (body mass index 30) identified as comparison subjects for ongoing case-control studies. Among the obese group, only 41.7% exhibited the A2 genotypes and 58.3% the A1 genotypes compared with 68.8% and 31.2% respectively for the average weight subjects (P=0.002). There was a similar pattern for B2 genotypes (51.4% compared with 78.9% respectively, P=0.003). The risk of obesity associated with the DRD2 A1 genotypes was 3.48 (95% confidence INTERVALS = 1.55, 7.80), compared with 4.55 (1.94, 10.69) for the DRD2 B1 genotypes. Individuals who had the A1 or B1 genotypes had higher BMI than those with the wildtype genotypes (P=0.086 and 0.05 respectively). The prevalence of the A1 genotypes was 2 of 5 (40%) obese individuals who never smoked, 12 of 22 (54.6%) for obese former smokers, and 7 of 9 (77.9%) for obese current smokers. The comparable percentages for the B1 genotypes were 0%, 56.5% and 55.6%. Further emphasis needs to be placed on identifying the genetic basis for obesity in order to develop targeted weight reduction interventions, that may improve potential for success.

    http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TB1-40BPS1B-6&_user=10&_coverDate=03%2F31%2F2000&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d817a7091773d8951d264125c9d1ff28
    -----------------------------------------------------------

    Spend some time with the obesity expert at your school, and you'll find out a lot more, and hopefully leave your ignorant and bigotted ideas behind. There are many reasons for obesity on the molecular level - it is like alcoholism or drug dependence - it is not simply a "willpower" issue. Anyone who thinks so is an idiot, and coincidentally probably not struggling with weight - coincidentally. Humans tend to lack any sympathy except for those that they can share negative exeriences. I'm sure there are many here who will make s**t doc's on the compasion side of the equation - the argument can be made that medicine needs a**holes too. Although I think they tend to be overrepresented and there should be no need for special consideration during the application process . . . but I'm off on a tangent . . . people who have toruble with weight have that problem for a reason - the same way people with high blood pressure have hypertension for a reason - a medical reason - and it is the onus of the health practicitioner to find how to help. I mean is it really to much to ask for a little common f***ing human decency? You have a personal problem with someone weight, perhaps you might want to look into your own narcissism?
     
  35. Critical Mass

    Critical Mass Guest

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    I'm not really in favor of any sort of quota system regardless of the trait measured.

    This part of the OP intrigues me (particularly the underlined section):

    I'm not sure that a radiologist has a "more sedentary lifestyle" than another specialist. Instead I might argue that radiologists have more time to exercise.

    Also, why would he/she find it awkward to "have" to tell patients to stop smoking, exercise, and lose weight? Are you saying that your friend doesn't want to heed such advice personally while at the same time remains worried about being too sedentary? I'm missing something here.

    I'm not touching the whole genetics issue, but every doc should advise smoking cessation.
     
  36. Tired

    Tired Fading away 7+ Year Member

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    Your study is a big pile of crap. Researchers consistently attempt to correlate genetic alleles with clinical syndromes, but the existence of a correlation does not indicate causality. Ditto on the "alcoholism gene" and all the other nonsense the pseudo-scientists like to toss around to blame genetics for simple human choices.

    Conservation of matter: you can't make something out of nothing. If you don't take in more calories than you expend, you lose weight. I'm not saying it's easy to do in the real world, but the priniciple itself is pretty basic. Eat less, exercise more.


    Regarding your hypertension example: Yeah, the medical reason is often that they're obese.

    Keep riding that line, and make sure you use it with your patients. "Don't worry, you were genetically predetermined to be huge. There's nothing you can do about it, might as well stop at McDonalds on your way home." That'll be doing them a big favor.

    Me? I usually just suggest they look into gastric bypass.
     
  37. AmoryBlaine

    AmoryBlaine the last tycoon 7+ Year Member

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    The BMI doesn't suck. It applied to the general population I'm sure that 95% of those it found to be overweight would have gotten there with good old adipocytes, not muscle mass.
     
  38. ut2010

    ut2010 Medical Student 2+ Year Member

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    I have been losing weight and I do notice a significant change in my energy level and ability to get more things accomplished in a day.

    I take time to exercise everyday and it really pays off dividends for health and other issues. I realized that exercising adds time to my day, other than the reverse. I feel so much better physically and it does help with self confidence. It is also a great stress release.

    Even though I have been overweight, I always have work hard and am very motivated. My efforts were in other directions rather than thinking about what was the calorie content of what I was eating.

    But, if I want to advocate healthy habits, I realized I need to think carefully about my own health condition first.

    Okay...I still struggle with my moutain dew craving :smuggrin: , but am becoming more aware of what I am eating.

    Part of the discrimination that overweight people face is real, I have experienced it, but if you are confident and competent....that will speak for itself. I never allowed myself to develop a bad attitude about it.

    And if a school will not consider overweight applicants and you are overweight, than obviously it is not a good fit for you. Just like if you don't have a very high MCAT score will preclude from certain schools.

    Hope you all are having a great day :D
     
  39. Stolenspatulas

    Stolenspatulas 2+ Year Member

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    One thing that pisses me off is the blatant hypocrisy. If I see a smoker smoking cigs that has lost his/her voicebox to cancer (and has to use one of those buzzy things to smoke), I automatically rush to judgment. That person is stupid for continuing to smoke. I mean, come on.

    However, when I see a morbidly obese person in line at Hardees I don't think the same things. I think I should. I mean, come on.
     
  40. Critical Mass

    Critical Mass Guest

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    :thumbup:
     
  41. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting.... Administrator Physician PhD Faculty Lifetime Donor Classifieds Approved 10+ Year Member

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    I may be in the minority here, but I assumed that the OP's post was a spoof, and it was a pretty funny one at that. The last paragraph in particular was really over the top. :laugh:

    OP, I will give you the immortal words of a guy I used to know, who was tremendously funny (and also rather rotund), when his doctor told him that he needed to get himself in better shape:

    "What do you mean, I'm not in shape? Round *is* a shape!!!"
     
  42. Doctor Bagel

    Doctor Bagel so cheap and juicy Moderator Emeritus 10+ Year Member

    For me this is based on the completely anecdotal experience of working with some truly workaholic overweight people. Not saying all workaholics are overweight, but I don't think there's any correlation between being overweight and being a lazy employee or student, which is what the above poster was arguing.

    Also, there is some genetic component of obesity. My first year in college, I ate more in general and more junk food than my roommate, and we both got about the same amount of exercise. However, I wasn't overweight, and she was. If you've lived with someone like that, it makes it clear that something else is going on that makes it harder for some people to keep weight off.
     
  43. jdh71

    jdh71 epiphany at nine thousand six hundred feet Physician 10+ Year Member

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    Pile of crap? A signifcant correlation and increased risk between a gene variant in obese people as compared to nonobese people? That is "crap"? It's merely one piece of the puzzle an clearly makes sense. Would it be so hard for you to wrap your ortho brain around the fact that altered brain physiology results in people eating too much, drinking too much, smoking too much meth - you have had a run in or two with meth-heads yes? All will power? Altered physiology also explains depression, anxiety, OCD - or why else would we treat these conditions with medications. Should the severly depressed patient be told all he needs is "will-power" - I mean it's a simple things of mind of over matter, quit thinking negative. You really have that hard of a time believing that obesity is more complex than your condescending an elitist attitude will allow? It's funny . . . there are two issues where my otherwise noble in every other respect colleagues lose their minds and become complete a**holes and that is obesity and smoking.

    You noticed that? Nice. It was an important concept in physics to be sure. But you are mistaking the symptoms for the disease. Being toed-up all the time is merely a symptom of alcoholism, which is based in other areas.

    Don't be dense. Just because there is a biologic/physiologic reason for obesity, does not relieve anyone of the responsibility to do something about it. Why would you think that? The alcoholic may have an explanation for his diseae but only he is responsibile for treating it. The hypertension analogy is good here - hypertension occurs for a reason - the reason is irrelevent to the presonal responsibility the patient has to treat the condition. Gastric bypass should be the last resort. Patient need to learn how to deal with their disease in a proper manner and just having surgery will only treat the symptoms, not the disease.
     
  44. Meltyman

    Meltyman 7" Member 2+ Year Member

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    :laugh:

    I like your avatar :p
     
  45. YupGypsy

    YupGypsy Banne*d for Tr*olling 10+ Year Member

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    someone's taking it too personal here...


    anyways, I'd rather be a thin/fit nobody than a fat cow with an MD.
     
  46. Tired Pigeon

    Tired Pigeon 7+ Year Member

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    :lol:
     
  47. Dr.Watson

    Dr.Watson 2+ Year Member

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  48. foofish

    foofish 7+ Year Member

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    Actually, the BMI doesn't correlate for a fair number of people, at both ends of the scale. I'm not advocating the "Oh, I'm not fat, I'm just big boned" excuse, but there *is* legitimate variation in bone/frame size and density throughout the population as well as the amount of muscle a person has. I have a cousin who was hospitalized for anorexia and was clinically deemed grossly underweight--she looked skeletal, with her hip bones, spine, etc. were protruding--but she was 135lbs...her BMI would have said she was overweight for her height. Now she is legitimately big-boned!

    The majority of serious athletes have an unrepresentative BMI, and people who are genetically very petite have a skewed BMI as well on the other end of the spectrum. The BMI is a good estimate for the middle of the population, but it's definitely not a perfect indicator.
     
  49. AnEyeLikeMars

    AnEyeLikeMars Member 7+ Year Member

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    Or, as my buddy said, "No no no, doc. It's not that I weigh too much for my height. It's that I'm too short for my weight. Fix that!"
     
  50. shantster

    shantster Eye protection! 10+ Year Member

    That is very true. Prior to my starting to weight lift this year I was right at the edge of being underweight according to the BMI, but my body fat percentage the last time I had it checked was 27%, which is just above the normal female range of 15 to 25%. They really should use body fat percentage instead of BMI, but I understand that it is more complicated if you are doing a quick screen (and you can't do it yourself).
     
  51. bsmcga0

    bsmcga0 Junior Member 10+ Year Member

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    true, guess I was saying the doctor was an idiot
     

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