Reconciling obesity Guidelines

[Peach Newport]

---

Members don't see this ad.

There are a few guidelines for determining obesity, so what do you do when they directly contradict each other?

I've heard the "reliable" sources tell me that BMI and waistline are reliable indicators.

So what do I do when a patient comes to me with a 24 BMI and a 40" waist? He doesn't show any sort of severe abdominal obesity or anything. His BMI says "normal," but his waistline meets the guideline for obese. I ask this in particular because I and one of my friends both have these same numbers.

Is there any consensus as to which measuring stick trumps the other?

 

[Solard]

Just out of curiosity, what shape is your friend?

 

[Peach Newport]

Just out of curiosity, what shape is your friend?

I am about 5'10 and 165 lbs, he's more like 5'7 and 155. I have a 41" waist and he has a 40" waist, measured at the level of the umbilicus, above the iliac crests. We both look the same - a bit chubby and not in great shape. But not exactly fat-flapping in the breeze either. My pants size is 34.

Both of our BMIs are in the "normal" range, but our waistlines are "obese." My doctor only uses BMI and tells me I'm fine.

 

[cbrons]

There are a few guidelines for determining obesity, so what do you do when they directly contradict each other?

I've heard the "reliable" sources tell me that BMI and waistline are reliable indicators.

So what do I do when a patient comes to me with a 24 BMI and a 40" waist? He doesn't show any sort of severe abdominal obesity or anything. His BMI says "normal," but his waistline meets the guideline for obese. I ask this in particular because I and one of my friends both have these same numbers.

Is there any consensus as to which measuring stick trumps the other?

What is your body fat percentagr by impedence measurements? BMI is not useful for every person.

Sent from my SM-N910P using SDN mobile

 

[Pepe18]

.

 

[HelpPleaseMD]

There are a few guidelines for determining obesity, so what do you do when they directly contradict each other?

I've heard the "reliable" sources tell me that BMI and waistline are reliable indicators.

So what do I do when a patient comes to me with a 24 BMI and a 40" waist? He doesn't show any sort of severe abdominal obesity or anything. His BMI says "normal," but his waistline meets the guideline for obese. I ask this in particular because I and one of my friends both have these same numbers.

Is there any consensus as to which measuring stick trumps the other?

Your fat seemed to have all accumulated in the worst possible place. Start exercising.
you can get a BIA but I suspect it will show severe sarcopenia of your extremities with high visceral fat which you just told us

 

[ZX10R]

I am about 5'10 and 165 lbs, he's more like 5'7 and 155. I have a 41" waist and he has a 40" waist, measured at the level of the umbilicus, above the iliac crests. We both look the same - a bit chubby and not in great shape. But not exactly fat-flapping in the breeze either. My pants size is 34.

Both of our BMIs are in the "normal" range, but our waistlines are "obese." My doctor only uses BMI and tells me I'm fine.

You sound like the stereotypical "skinny-fat" as people like to call it on the interwebs. Which as two others in the thread have eluded to is one of the worst types to have when it comes to risk factors for diseases. Also size 34 with a 41" waist??? what??

To answer your question BMI/Waist were meant to accommodate for +/-2 standard deviations aka ~95% of the population. But since we are in the health field we have a biased sample size, obviously, because get this; weird BMI's tend to be caused by disease states and will be seen at hospitals more. The best thing to do in these scenarios is to use good reasoning. If its a dude with a 6 pack outside his desired BMI you don't need to bring it up. If it's someone with an abnormal waist size or unorthodox fat distribution you can make proper recommendations. In the end BMI is only a tool, a great tool for research purposes due to the trends that it can establish, but as with any tool you learn how to use it better with experience.

I think what your trying to look for is the waist-to-height ratio or more commonly waist-to-hip which the WHO, International Diabetes Federation, American Heart Association, ect have all found to show increased risk factor for diseases. What it lacks though is the history and research standards that BMI provides.

 

[PL198]

Your fat seemed to have all accumulated in the worst possible place. Start exercising.
you can get a BIA but I suspect it will show severe sarcopenia of your extremities with high visceral fat which you just told us

OP is a medical student so likely 20s or 30s. You think they have severe sarcopenia?

 

[Peach Newport]

This guy has a 38" waist. Adding 2" to that is easy.

 

[cbrons]

Also size 34 with a 41" waist??? what??

Yes this does indeed sound strange.

 

[Donald Juan]

Yes this does indeed sound strange.

Almost all pants companies have much smaller numbers than the real size of them.