BMI? reliable or just a short cut?

[nealiiih]

Hello everyone!

I just joined and this is my first post, I love the site! Forgive me if I've posted in the wrong area for this topic.

Does anyone here believe in the use of BMI? I have read across journals that it is a quick and easy reference tool for practitioners to use. Is it an accurate and/or valid tool to use to advise your patients on health/wellness/need for weight loss? In my opinion, I look at a more holistic approach rather than just BMI- vitals, lipid panels, labs, clinical presentation, activity, and the patients general feeling of wellness, except for when the patient is clearly obese or the lifestyle could clearly benefit from some weight loss.

I'm asking as a nurse and a patient. Last week, I got a birth control refill and their process at the women's health clinic is to conduct a brief assessment before giving the refill prescitoption. I had an NP who looked early 30's (my age) but she's almost a size zero, and living in Southern California, this seems to be the norm....but I digress.

I'm 150 lbs 5'5" though I lift and do cardio and yoga four times a week, I mostly eat clean, have muscle mass and do not have a dainty bone structure, I am a size 6. Nonetheless, my BMI is barely 25, which is considered 'overweight.' the cut off is 149 lbs for my height which then would be a BMI of 24 which would be "healthy weight range." This I can handle.

What I can't handle is she used my upcoming wedding as a way to open the conversation about me loosing weight. "Don't you want to get in better shape for your wedding?" she asked. (Earlier in the assessment she noticed the ring on my finger, assumed I was married, I corrected her and said I was engaged) She mentioned "loosing weight for my wedding" not once but twice and mentioned my BMI. I told her I'm a size 6 and short of starvation paired with my current activity level, weight loss is an immense struggle. Please note my BP was 91/60 HR 65. My lipids are great. I wish I could bottle it up and sell it.

I had the feeling she was looking at numbers only and not the actual patient, head buried in chart. I left the clinic in tears (silly me). As an RN, I would never advise a patient to loose weight based on a borderline BMI alone, she had not asked about lifestyle or activity level or anything, all she could see was that number. Does all that matter? The consensus across the internet and a few medical journals is that BMI is bogus, but then why do practitioners continue to use this as a standardized tool?

[FlyingScot, RN]

We have a health initiative for employees where I work. We have to undergo a biometric screening. My BFF is 5' 7" 127-130lbs. The nurse asked her if she was "satisfied with her weight" implying that she could lose a few pounds. She left in tears feeling like a fat cow. Trust me, I made a very angry phone call regarding the nurse's extreme lack of professionalism, tact and ability to properly assess patients. But what I really wanted to do was go kick her in the shins.

[blondenurse12, MSN, NP]

Yeah, I think BMI is really simplistic and it targets the wrong people. I know growing up, my pediatrician would always say "well your BMI is high, you need to lose weight". I played sports and made family meals so I was in charge of what we ate.

Much like the OP, my BMI hovers around 24-25. I am 5'6, 150 pounds and I wear a size 2 or 4 depending on the brand. My body fat is 22%. Bodyfat is a much better predictor but it takes more time and can be slightly uncomfortable if you are using calipers.

I think it's funny because what does a BMI tell you that you can't see with your own eyes? It's an arbitrary meaningful use thing, not that it has any useful meaning :)

[LV3677]

BMI does not take into account that muscle weighs more than fat. Therefore, extremely fit/muscular individuals will typically fall into the overweight/obese section of the scale. BMI is supposed to be a quick tool for assessing weight; however, it does not take into account other factors, such as where the weight is displaced.

BMI is not reliable as an indication of healthy weight; it's a statistic.

[NotReady4PrimeTime, RN]

A pound of muscle doesn't weigh less than a pound of fat, but it does take up considerably less space. That's how two people who are the same height and weight wear different sizes. The one with the most muscle will wear the smallest size.