But don’t the “healthy weight for height” ranges in adult weight range charts essentially say the same thing as “BMI 19-25”? That would have the same issue that BMI does, in that some people are heavy with muscle (some athletes and manual laborers) while others are in the “healthy weight” range but have higher than typical body fat percentage and are therefore more at risk of obesity-associated health problems (“normal weight obesity” or “skinny fat”).
No matter what we (the country and maybe the world?) do, people just keep getting fatter and fatter. And the reasons are pretty clear now. But a palatable solution (no pun intended) for the masses doesn’t exist.
I always notice this in old photos and videos. Kids also got a lot more exercise back then. While there are kids now who participate in a sport or sports at intense levels, the majority don’t. The main exercise they get is using their phones or playing video games. I’m sure we all remember being outside a lot as kids, riding our bikes everywhere, playing outdoor games. And if we were inside, many of us were reading books.
I don’t know what the answer is. There will be a lot more people in the future who have health issues because of this. I guess we will have to just accept this, just as we might have to accept that we will have a significant percent of the population with issues because of long covid.
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Our health care system has already been experiencing high costs (direct and indirect) due to the obesity epidemic for at least several decades.
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You are right. Do you know if there has been any progress made? Or do the obesity stats just keep getting worse and worse? (I suspect this is the case.)
Definitely increasing.
- The US obesity prevalence was 41.9% in 2017 – March 2020. (NHANES, 2021)
- From 1999 –2000 through 2017 –March 2020, US obesity prevalence increased from 30.5% to 41.9%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%. (NHANES, 2021)
Add in the 1/3 of people who are overweight (BMI 25-29), it’s close to 3/4 of the US population that is either overweight or obese. Even thought BMI has its issues, it is the standard metric for measuring proportion of the population obese or overweight.
So all the healthy eating and exercising hasn’t made a dent at the population level. I guess there hasn’t been much healthy eating and exercising overall.
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BMI tracking for a population makes sense, help see trends such as above. And for one person it can be a helpful heads-up indicator. But there are definitely cases where it is misleading. In college I knew a very fit and muscular gal who had trouble on military qualifications.
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I use one of those electronic scales with measuring waist, hips and height. Yes, they are not fully accurate but I don’t care. It motivates me to lose weight. I get a read out of like 10 different parameters. My blood pressure and cholesterol are in normal range for like the first time in my life. Lose weight and eat healthier and exercise.
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I listened to the podcast linked above. Interesting history, but the part that stuck with me, negatively, is the tendency to dismiss health concerns when overweight/obese just because some doctors attribute everything ill to weight.
I totally get what they are saying about medical bias. About 20 years ago, I went to see a doctor about my bum knee, and the doctor told me to lose weight. I told the doctor the pain started when I was running marathons and an ultramarathon and had to quit, leading to the weight gain, so, no, losing some weight was not going to fix this knee. I never went back. So I get what the podcasters are saying about how the BMI is flawed and a poor measure of health. However …
There are people, like my sister, who are obese and flat-out refuse to take responsibility for their health. Normally, I wouldn’t want to say a thing, but we are in the throes of caring for my 91yo mother in her home, and my sister’s repeated ER visits show she is not in good enough shape to take care of our mom. The main caregivers, because they are in town, are my sister and SIL and one of them has been in the ER three of the past four months. Their plan to take care of our mom themselves isn’t sustainable. Anyway, I still haven’t said a thing, but I’m getting close because when one of them goes down guess who is expected to ride to the rescue? This last time she had Covid and joked to her boss that she’s “fat, old, diabetic and has asthma so, of course, it hit me hard.” Yeah, especially because you never got boosted either.
Anyway, don’t want to derail this, and I am all for body positivity (go, Lizzo!), but when there ARE proven health repercussions that can be tied to weight and poor dietary habits I think it’s a disservice to dance around that.
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Absolutely. My FIL died at 72. He got heavy in his 40s. He had two heart attacks and then developed diabetes, and that’s what eventually killed him. Literally every time we saw him, he lectured DH about keeping his weight down. DH is the only one out of five siblings to take the advice to heart. Thank God! He’s 69 but people don’t believe him when he tells them his age. I worry about his siblings. I think they’re all in the obese range. 
Here’s the chart, but personally, I think it’s WAY outdated, but that’s another discussion.
https://body-comp.com/resources/dexa-report/body-fat-chart/
For a male, “8%-19%” is “ideal” IMO. Of course, “ideal” is a relative concept.
And BTW, I’m VERY healthy and I’m in the blue zone for not only for my age group, but younger age groups as well. 
I’ll add that I’m on record here that I think BMI is a very flawed measure. Kaiser, my HCP, uses it when I walk in for my “physical” each and every time. I’m on the cusp of being considered overweight by BMI standards. I’m not.
I mentioned a few weeks ago that a fellow gym member in his 30’s had to pay a higher life insurance rate, because he was considered nearly obese by BMI standards, but if you would look at him, you would see he’s nowhere close to being obese.
I’ve had DEXA’s and hydrostatic (dunk tank) testing here in the SF Bay Area. You could schedule one of them almost every day of the week here, since they both (tests) have mobile units. The results of both have been relatively similar.
My D is in her 6th year of a general surgery residency, she will be going into bariatric surgery for fellowship. Definitely a very popular surgical specialty and a surplus of patients wanting gastric bypass or sleeves. One data point, D had a fellowship interview with a program that had 1400 applicants, only interviewed 20 and will take 2. Huge field as more of the population continues to be obese.
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But if you walk in and the physician and other health care people see you in person, then they will recognize you as “overweight with muscle” (i.e. no added risk of obesity-related health problems) rather than the more typical “overweight with fat” (i.e. added risk of obesity-related health problems), right?
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But if the fellowship programs for the specialty are that tiny relative to both the number of interested physicians and the number of patients, that suggest that this “huge field” will continue to be underserved.
I don’t know what my HCP sees or writes down in my chart, but as mentioned above, I’m in the blue zone in terms of body fat % and considered very lean.
Someone mentioned this in a conversation the other day that we’re unfortunately becoming like the society portrayed in the movie WALL-E.
However, there’s a diabetes drug, Ozempic, that appears to becoming popular for weight loss. Now, if they could invent a pill for increasing and maintaining muscle mass.
Has your health care provider asked or surveyed your exercise habits? Probably yours are off the normal scale at the high end, so they know that you are not one of the people they should recommend to do more exercise.
Generic name is semiglutide.
Ozempic has been prescribed off-label for weight loss, sometimes to the annoyance of type 2 diabetics who find it sold out when they try to buy it for its intended use. The weight loss (probably due at least in part to effects like nausea and other digestive effects that reduce the urge to eat) is often a welcome side effect for obese type 2 diabetics.
Semiglutide is now also offered under the brand name Wegovy with FDA approval specifically for weight loss.
“But if the fellowship programs for the specialty are that tiny relative to both the number of interested physicians and the number of patients, that suggest that this “huge field” will continue to be underserved.”
Very true. The same problem exists for Dr.s in general. Not enough training facilities. I’m sure @WayOutWestMom can explain it better.