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Men may be thinner than they thought

3rd April 2012

Researchers in the United States say that the country's obesity epidemic may be worse than previously believed, casting doubts on the traditional formula used to calculate healthy weight levels, the body mass index, or BMI.

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The BMI, which takes into account a person's height and weight, may be classifying as many as 50% of women as "normal" when they should be considered overweight or obese, according to a new report in the journal PLoS One.

In addition, more than a fifth of men may have been told their weight is just fine, instead of that they need to shed some pounds.

The study suggests replacing the 180-year-old BMI with the ratio of a person's fat to lean muscle mass as the new "gold standard" for determining whether they are overweight or obese.

However, this measurement requires an expensive diagnostic test called dual-energy x-ray absorptiometry, or DXA. It can use fat composition standards used by the American Society of Bariatric Physicians to calculate a person's level of obesity.

The study also found that while many women considered normal under the BMI standard became obese with the DXA calculation, many men considered overweight using the BMI became normal when the DXA assessment method was used.

The study of 1,393 patients in Manhattan was authored by New York's state commissioner of health Nirav Shah and internal medicine specialist Eric Braverman from New York City.

They conclude that America may be "much further behind than we thought" in resolving the country's obesity crisis.

Braverman said the BMI was partly to blame for the failure of public health policies to get to grips with obesity, calling it "baloney".

Obesity expert James Hebert said public health policy-makers were "stuck" in the face of America's worsening obesity problem, and was casting about for new ways to tackle the issue.

He described the new findings as "holding promise".

Researchers have examined waist circumference, hip circumference and waist-to-hip ratios as possibly alternatives to the BMI when assessing the success of weight-loss programmes, which range from psychological counselling to exercise regimes, to drug treatments.

University of Alabama researchers are getting ready to look at whether a computer can analyse photos of a patient and produce an accurate estimate of their fat deposition, musculature and work out which fat deposits could be dangerous to their health.

Critics have already pointed out that the DXA is too costly for regular scanning use, and may not itself provide a perfect measure of obesity.

High BMI has been linked reliably in past studies to an increased incidence of type 2 diabetes, cardiovascular disease and certain cancers. However, it is hard to gauge whether or not the change in measurement reported in the study means that more people are in poorer health than previously was thought.


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