Measuring the body mass index (BMI) is the first step in determining if a patient is overweight. The BMI is easy to measure, reliable and correlates well with the percentage of body fat – it’s more accurate in assessing body fat than weight alone. The relationship between BMI and percent body fat is different among different ethnic groups. The risk of future disease is reached at a lower BMI for certain groups (South Asians) and in others at a higher BMI (blacks) as compared to whites. In the United States, the risk of becoming overweight is 50% and the risk of becoming obese is 25%.
The highlight from this week’s New England Journal of Medicine is that fatter people were more likely to die from all causes. A meta-analysis (a study of many studies) yielded not surprising news. Persons with a BMI of 25-29.9 (overweight) had 13% increased mortality and those patients with a BMI of 35-39% increased their risk of death by 88%.
After studying 1.5 million patients, the authors of the study concluded that the optimal BMI is 20-24.9. Achieving a BMI of less than 22 in the mature adult can be challenging, especially if food intake is so restricted that one worries about nutritional deficiencies. The optimal body weight for any person should be part of a health maintenance discussion.
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