The cultural-idiom “big-boned” is often used colloquially to describe someone with a larger frame or body. Although variations in bone structure exist among individuals, such factors don’t typically play a significant role in diagnosing obesity. In fact, researchers have unearthed a trend of metabolically healthy obese (MHO) adults that push body mass index (BMI) limits while avoiding disorders like high cholesterol and hypertension. Simply stated, a bigger human is not necessarily an unhealthier human.
Per the Centers for Disease Control and Prevention, BMI is “a person’s weight in kilograms (or pounds) divided by the square of height in meters (or feet).” The tool is a rough indicator to screen for specific weight categories that may increase an individual’s risk for health problems.
In an article published on the JAMA Network Open site on March 9, 2023, a team of medical scientists from China-based Huazhong University of Science and Technology and Hubei University of Medicine reported a rise in MHO adults from 1999 to 2018. The study included 20,430 US participants and spanned various sociodemographic groups. Historically, experts have concluded that an elevated BMI is associated with an increased risk for high cholesterol, hypertension, and type 2 diabetes. But the analysis led by Jiang-Shui Wang illustrated that many overweight people defy the odds and typical physiological disorders associated with being obese.
Consider this before switching back to the whole milk in your morning latte: fewer than 7% of study participants were considered MHO, a small fraction of the total surveyed. Among the group were individuals who scored high on the BMI due to larger bone structures and/or muscle mass but showed zero signs of disease or illness. Jiang-Shui believes the results “highlight the need for effective strategies to optimize metabolic status and prevent obesity-related complications” among overweight individuals.
My BMI is...
A. Less than 18.5 (underweight range)
B. 18.5 to <25 (healthy range)
C. 25.0 to <30 (overweight range)
D. 30.0 or higher (obesity range)
The BMI is considered outdated and limited in scope because it fails to account for the distribution of muscle, bone, and fat in the body. For example, 2 people with identical readings could have vastly different physical frames - one might have a higher proportion of muscle, while the other may carry more adipose tissue, or fat. Progressive medical experts recommend a more comprehensive approach that includes a thorough personal history, physical examination, and consideration of health factors to accurately assess an individual’s well-being.
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