A MARTÍNEZ, HOST:
Want to know if your body fat is in the healthy range? Well, stepping on a scale is not the best way to figure that out. An international panel of experts is now recommending a more nuanced and objective way. Here's NPR's Allison Aubrey.
ALLISON AUBREY, BYLINE: There's plenty of stigma associated with having a larger body size. And one common assumption is that everyone with a high BMI - or body mass index - is unhealthy and needs to lose weight. Kezia Reeder knows what it feels like to be categorized as obese.
KEZIA REEDER: I'm shorter and muscular. By no means am I, like, an Olympic athlete, but I'm athletic. At the time when my BMI was categorized as obese, I was running half-marathons.
AUBREY: For many years, the main way doctors have determined whether a person has obesity is by calculating their BMI. It's a quick and inexpensive estimate based on just weight and height. Since stocky, muscular people weigh more, they tend to have higher BMIs.
REEDER: It's enraging because I know I am a healthy, active individual.
AUBREY: Her lab tests showed she was metabolically healthy. Many experts agree BMI is not a good measure of health. Dr. Robert Kushner of Northwestern University was part of the panel that came up with the new recommendations.
ROBERT KUSHNER: Forty percent of the adult population in America, according to BMI, has obesity. So do they all have a disease, and do they all need treatment?
AUBREY: Dr. Kushner says the commission's goal is to bring some clarity to these questions, since the current method has led to misclassifications and confusion.
KUSHNER: What's new is that we try to define obesity by excess body fat, which is what obesity actually is, that goes beyond just using BMI.
AUBREY: The commission recommends adding measures such as waist circumference or waist to hip ratio, or to use direct measures of body fat through screening techniques, such as a DEXA scan, when available and affordable. Dr. Kushner says the problem with BMI alone is that a person who is muscular and athletic, like Kezia Reeder, may be told they have obesity even if they have very little body fat.
KUSHNER: So although we're not throwing out BMI, we are now recommending that individuals have another measurement obtained that more directly gets an estimate of body fat, such as waist circumference.
AUBREY: The reason there's a focus on weight around the middle of the body is that too much of it can be harmful.
KUSHNER: Fat in the belly causes systemic inflammation, which then goes on and causes other metabolic problems like elevated blood sugar, elevated blood pressure and increased fats in the blood.
AUBREY: Setting the stage for metabolic diseases, including diabetes as well as heart disease. The experts say this reframing of BMI offers a more nuanced and objective way to assess body composition. Kezia Reeder struggled with an eating disorder in college and has been in recovery for many years.
REEDER: I have plenty of examples of how I felt stigma around my weight and/or BMI being used as a measure of, quote-unquote, "health."
AUBREY: She now works with The Emily Program, an eating disorder treatment center, and says she applauds the new recommended changes.
REEDER: I'm really encouraged by medical providers and health systems moving away from using BMI as an indicator of health.
AUBREY: The aim is to move towards more personalized care, something she and the experts agree on.
Allison Aubrey, NPR News.
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