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  1. #1
    Biscuit Boy Cosmoline's Avatar
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    "Morbidly Obese," Still Somehow Alive

    I've been car free for over two years now and doing more and more cycling. So far this spring my cycling has increased to new heights. I did a half century last week and followed it up on the weekend with cargo hauling and shopping of about 16 miles total, including hauling mass amounts back from Costco. I no longer need to dismount for most hills, and I can keep a steady if not exactly speedy pace in headwind. In the mean time my resting blood pressure has fallen back into high normal range and is still decreasing, resting heart rate has dropped and overall health improved. Joint and back pain has also gradually reduced. I have a game left knee but as a good ortho advised me the more cycling I've done, the more muscles have developed to compensate for the weakness of the joint.

    At the same time, my weight has been going down only gradually as muscle mass increases and fat decreases. All well and good, except that according to the sanctified chart I am still over 48 BMI and about to die! I would be a candidate for emergency surgery! I've also been rejected as a bone marrow donor because of this number, even though my overall health is excellent for a 39 year old and I can easily pass any treadmill EKG or other test they want to run on my innards.

    Now I grant that I am something of a monsterous mutant. I"m quite thin at 200-210. That's what I weighed in my prime of fitness in my early 20's. The fact is they simply did not make humans like me in the 1830's when that chart was devised. Thanks to modern food production and nutrition, every part of me is on a larger scale, from feet to hat size, than a person of that era. I've seen their clothes and read the military reports from the era describing in cold numbers the massively under-nourished European population. I'm also the product of genetic combinations that were unknown at the time, leaving me with somewhat thick stumpy legs and an extra-long torso. BMI takes no account of ANY of this.

    But that said, I'm far from the only one who's reality diverges sharply from the archaic BMI measurements. I would say that the error is harmless except that in my case, if I chose, it would lead to a dangerous and totally unnecessary surgery. Further, it may have already cost lives by denying my rare tissue type to those in need of marrow.

    What can we do to stop this idiocy? Short of kicking doctors who use the charts in the groin so hard they'll never have kids.
    Last edited by Cosmoline; 05-06-09 at 05:24 PM.
    ''On a bicycle you're not insulated. You're in contact with the landscape and all manner of people you'd never meet if you were in a car. A fat man on a bicycle is nobody's enemy.''

    Tom Vernon.

  2. #2
    The Site Administrator: Currently at home recovering from a couple of strokes,please contact my assistnt admins for forum issues Tom Stormcrowe's Avatar
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    The chief problem with BMI is that it isn't really a "medical" standard, per se, but instead, a statistical standard used to compute risks for insurance. For a person of average skeletal build, yeah, it's most of the population, but we also have to remember, any statistical study has outliers as well, and Higher than standard BMI doesn't equate to being unfit.

    Yes, you will burn more O2 carrying the extra mass, and this affects your ability to sprint, and can affect your time in VO2 max, but that doesn't mean you aren't fit. The best parallel I can think of is a Greyhound vs a Big St Bernard. Both are great for the task their respective physiques are suited for. Neither one is unhealthy, they just have individual differences.
    on light duty due to illness; please contact my assistants for forum issues. They are Siu Blue Wind, or CbadRider or the other 3 star folk. I am currently at home recovering from a couple of strokes. I am making good progress, happily.


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  3. #3
    Joyously Phred MnHillBilly's Avatar
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    Well, I see logic on both sides of the coin, having been on both sides of each coin.

    Yes, BMI isn't a standard we should all be held too as strictly as insurers and docs sometimes do. But there's still something true about a BMI of 35 and above still statistically increasing risk of chronic disease.

    I was a BMI of 65 before I opted to have surgery. I'm now in a BMI of 38 and would be comfortable and healthy enough if I remained here. I have 60 more pounds I could reasonably lose before I'm at my "lowest" comfortable weight. My blood pressure is perfection, I no longer take asthma meds, I can bike and haul and do 5K jogs.

    But the fact remains that I'm still putting my joints through the ringer carrying these extra 60 pounds on my frame. The fact remains that it takes more effort than it should to climb when I'm on my bike because I'm carrying that extra body weight. Even though I'm in good health.

    The last 60 would put me at 200 lbs for a 5'9" female frame and a BMI hovering around 30. I would still technically be obese according to the BMI chart. But I would need further surgery to get to my "technically ok" BMI.

    So - kudos to you that you're taking care of yourself and getting active - keep it up! But I would caution that health isn't always wrapped up in what you can "do" either, though it's a big part of it. It's often the things we don't see or worry about (underlying blood pressure, heart concerns, getting winded after a big effort) that catch up with us. I bet you're feeling terrific even at a 48 BMI - but imagine how much better you'd feel if you continued and reached a BMI in the 30's?

    I think what needs to get tossed is the idea of BMI having to be within the set 5-pt range, but BMI is useful when you look at it more broadly. You may never get to 25, but it may be possible to rest at 28 or 30. It's really hard to achieve a BMI of 35 just from primarily muscle mass, even people who are tall with large frames. It's best to think of BMI as a ballpark. 23-30, you're doing fine. 30-40, there's room for improvement. 40+, you need to make loss a priority.

    Keep biking, watch your intake, you'll get to the BMI that suits you best eventually. It's not a race.
    "Took a whole lotta tr-y-in' jest ta get up that hill"

  4. #4
    Biscuit Boy Cosmoline's Avatar
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    I agree health is mostly about what we don't see--and that's exactly why BMI is utterly worthless as a diagnostic tool. Whether it still has any use as a statistical tool after all these centuries I'll leave to the statistics people, but that has NOTHING to do with a particular person's health. The chart was never, ever, ever intended to be used as a guidepost for individuals. It's for crunching large masses of data about, well, large masses. No doctor should be citing it under any circumstances as a diagnostic tool, because it's useless in that role. He needs to check BP, resting and active heart rate, run heart tests, and if fat is an issue do the dunk tank to find out the ACTUAL amount of fat load a person is carrying. I'm heavy, but a fair chunk of it is muscle and bone. That's why I can still be active and healthy at my weight.

    Obviously I'm planning on losing more, but that @$#@ chart has been a source of irritation my whole life. Telling me I was fat when I absolutely was not fat, and now telling me I'm bound to die even though I'm not. The goal must be overall health, NOT getting yourself to a better place on some archaic statistical chart.

    40+, you need to make loss a priority.
    This is the sort of nonsense that really bugs me. You take a figure from an archaic statistical chart and attempt to apply it to someone you've never even seen. Fact is, I'm doing fine at my size. I'm not as spry as I was or as I'd like to be, but my PRIORITY is nutrition, heart rate, blood pressure, and actual health. NOT a number on a chart from the 1830's that I have NO hope of EVER matching! I have never been healthy according to that thing, even when I was young fit and swam a mile a day.

    but imagine how much better you'd feel if you continued and reached a BMI in the 30's?
    With a chainsaw or yet another crash diet I'm sure I could get there again in no time. I have done it before--AND FELT LIKE GARBAGE. I was hungry all the time, and gained it all back and more. Because people are not numbers on some nasty old Belgian's chart. This time I specifically opted to make PERMANENT LIFESTYLE CHANGES and forget about trying to lose X lbs. in X weeks so I could have a BMI of XX by Christmas. I have been down that road over and over again, it leads nowhere. I suppose if I let some quack cut on my stomach I could do it, but I love my innards and I find the prospect of hacking them out or squeezing away my beloved stomach to be horrific. So instead I focus on good nutrition with reasonable portions at set times. It's working slowly, but that's fine. Indeed that's the whole point. Rapid loss only leads to more rapid gain.
    Last edited by Cosmoline; 05-06-09 at 07:35 PM.
    ''On a bicycle you're not insulated. You're in contact with the landscape and all manner of people you'd never meet if you were in a car. A fat man on a bicycle is nobody's enemy.''

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  5. #5
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    Quote Originally Posted by Tom Stormcrowe View Post
    The chief problem with BMI is that it isn't really a "medical" standard, per se, but instead, a statistical standard used to compute risks for insurance. For a person of average skeletal build, yeah, it's most of the population, but we also have to remember, any statistical study has outliers as well, and Higher than standard BMI doesn't equate to being unfit.

    Yes, you will burn more O2 carrying the extra mass, and this affects your ability to sprint, and can affect your time in VO2 max, but that doesn't mean you aren't fit. The best parallel I can think of is a Greyhound vs a Big St Bernard. Both are great for the task their respective physiques are suited for. Neither one is unhealthy, they just have individual differences.


    Its like thoroughbreds and clydesdales even a clyde can be in good shape

  6. #6
    Senior Member Wogster's Avatar
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    Quote Originally Posted by Cosmoline View Post
    I've been car free for over two years now and doing more and more cycling. So far this spring my cycling has increased to new heights. I did a half century last week and followed it up on the weekend with cargo hauling and shopping of about 16 miles total, including hauling mass amounts back from Costco. I no longer need to dismount for most hills, and I can keep a steady if not exactly speedy pace in headwind. In the mean time my resting blood pressure has fallen back into high normal range and is still decreasing, resting heart rate has dropped and overall health improved. Joint and back pain has also gradually reduced. I have a game left knee but as a good ortho advised me the more cycling I've done, the more muscles have developed to compensate for the weakness of the joint.

    At the same time, my weight has been going down only gradually as muscle mass increases and fat decreases. All well and good, except that according to the sanctified chart I am still over 48 BMI and about to die! I would be a candidate for emergency surgery! I've also been rejected as a bone marrow donor because of this number, even though my overall health is excellent for a 39 year old and I can easily pass any treadmill EKG or other test they want to run on my innards.

    Now I grant that I am something of a monsterous mutant. I"m quite thin at 200-210. That's what I weighed in my prime of fitness in my early 20's. The fact is they simply did not make humans like me in the 1830's when that chart was devised. Thanks to modern food production and nutrition, every part of me is on a larger scale, from feet to hat size, than a person of that era. I've seen their clothes and read the military reports from the era describing in cold numbers the massively under-nourished European population. I'm also the product of genetic combinations that were unknown at the time, leaving me with somewhat thick stumpy legs and an extra-long torso. BMI takes no account of ANY of this.

    But that said, I'm far from the only one who's reality diverges sharply from the archaic BMI measurements. I would say that the error is harmless except that in my case, if I chose, it would lead to a dangerous and totally unnecessary surgery. Further, it may have already cost lives by denying my rare tissue type to those in need of marrow.

    What can we do to stop this idiocy? Short of kicking doctors who use the charts in the groin so hard they'll never have kids.
    I'm going to partly agree with a lot of other responses, BMI alone is not an indicator of health, however it is an investigative tool. For example a doctor who says you have a BMI of 48, I should really run a few tests, to check your blood sugar and cholesterol. Since these ARE indicators of overall health, along with blood pressure. So is your general appearance, if you have a spare tire that would fit a mining truck then obviously that is more of a concern then if your spare tire would fit a mountain bike,

  7. #7
    Senior Member atcfoody's Avatar
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    Welcome to one of my biggest pet peeves, second only to using a scale to determine health (I'll save you all the ranting).
    I still rate in the "borderline obese" category myself, but when I tell my students that, they all just laugh. I try and stress to them that the best indicators of health are heart rate and blood pressure (the lower the better), along with blood chemistry numbers (cholesterol, blood glucose, etc). After that it's all about how your cloths fit.

    D

    p.s. Even though I still tip the scales at 235ish, I'm now able to comfortably fit into a size Large polo shirt. No more XL's for me!
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  8. #8
    On the road to health. Griffin2020's Avatar
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    You need to find a doctor that has a Tanita full body scale. They use electrical inductance to measure body make-up. They can tell how much free fat mass, muscle mass, water mass, etc.

    This is a much better indication of true fat % instead of an outdated chart.

  9. #9
    dolce far niente prxmid's Avatar
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    Second the full body scale. I going to a weight loss Doctor and every 2 weeks I get on the scale

    In 10 seconds it gives you Bas metabolic rate (what you burn at rest), BMI, water weight
    % fat in torso, arms, legs, muscle mass, etc.

    When you lose lbs it measure how much is fat loss vs water weight. at aprox 3500 calories burned per lb loss, you can figure how much you have to take in below yur base metabolic rate to lose weight. For instance my bmr is about 2250 calories, and my plan is 1160 per day, averaging about 11lb loss per month. More with exercise

  10. #10
    Fat man on a little bike. Big Fat Paulie's Avatar
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    Large

    You call 200-210 large, hah. Try 335-365. At 200-210 you may be larger then the toothoik folks but man i would trade my left bollock to be 200-210. I will get there though I mile at a time.

  11. #11
    dolce far niente prxmid's Avatar
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    I read it that way at first. I think he said he was thin at 210 MANY years ago

  12. #12
    Laid back bent rider unixpro's Avatar
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    My BMI is also way off scale. Not as bad as yours, but at 38 the company life insurance company said I couldn't get the supplemental insurance because I was surely about to die. However, when I go to the doctor next week I expect him to tell me I'm fine and to keep it up. My body fat isn't where I'd like it to be, but it also isn't anywhere near as bad as 90% of the people I see driving their cars. At 5'6" and 248 pounds, I wear a size 38 pants. My legs are rock solid, as is most of my stomach, which you can actually see. I can look down my body and see both my tinkler and my toes without having to go into contortions. I ride 36 miles/day, 5 days/week, with 2,400 feet of climbing every day. According to my HRM, I burn between 1750 and 2300 cal/day, depending on the weather. I don't know *anybody* who works out as much as I do.

    I've said it before and I'll say it again. BMI is BS.

  13. #13
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    Quote Originally Posted by Cosmoline View Post
    Obviously I'm planning on losing more, but that @$#@ chart has been a source of irritation my whole life. Telling me I was fat when I absolutely was not fat, and now telling me I'm bound to die even though I'm not. The goal must be overall health, NOT getting yourself to a better place on some archaic statistical chart.
    But you are bound to die. But the healthier you are, the longer you can procrastinate thie "to do" item.

  14. #14
    a big man
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    studies have found that BMI is a poor indicator of bad health events. The best indicators were waist measurement, and even better was waist to hip ratio.

    http://cme.medscape.com/viewarticle/516170

    In general, however, I doubt that someone with a BMI of 48 is "healthy". 39 years is still quite young. Staying at your weight will eventually catch up with you. Calculate your waist to hip and tell us what that is.

    Or better yet, take a shirtless pic and we can see how fit you really are.
    Last edited by justin70; 05-08-09 at 05:51 PM.

  15. #15
    Biscuit Boy Cosmoline's Avatar
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    I doubt that someone with a BMI of 48 is "healthy".
    Well tell me how I'm unhealthy, then. The number is an arbitrary statistical tool, and was never intended for diagnosis. Health depends on the individual's actual medical status. I'm on no medications whatsoever, I'm in no pain to speak of other than periodic muscle aches after workouts. I have no difficulty breathing. My BP and heart rate are higher than I'd like but not particularly dangerous, and they're steadily decreasing. I get regular checkups. I'm not as quick as a smaller person, but then again I could pick that small person up and break him, or just kick his knee backwards.

    So really the only problem is the extra fat, but fat per se does not make you unhealthy. It has been associated with medical problems, but the studies to date have done a poor job differentiating between medical problems caused by fat per se and those caused by inactivity and bad diets. Moreover a study is looking at patterns, it says nothing about any particular person. The biggest direct problem appears to be pressure on the joints, and that's the main reason I'm losing the extra pounds. Also because of my left knee injury, which is mainly what caused me to put on weight in the first place.

    I'm not disputing that I need to lose weight. I'm saying that I am healthy now even though according to the BMI number I'm "morbidly obese." You would never look at me and call me thin. I'm a mountain with enormous leg muscles. But nobody would see me and think "gosh he's about to die from his fat." Nor would they ever imagine how much I actually weigh. I'm not a person who develops a beer belly. My fat is evenly distributed. None of this is taken into account on the BMI, which is why it's utterly useless as anything but an arbitrary statistical tool.
    Last edited by Cosmoline; 05-08-09 at 06:58 PM.
    ''On a bicycle you're not insulated. You're in contact with the landscape and all manner of people you'd never meet if you were in a car. A fat man on a bicycle is nobody's enemy.''

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  16. #16
    a big man
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    Quote Originally Posted by Cosmoline View Post
    Well tell me how I'm unhealthy, then. The number is an arbitrary statistical tool, and was never intended for diagnosis. Health depends on the individual's actual medical status. I'm on no medications whatsoever, I'm in no pain to speak of other than periodic muscle aches after workouts. I have no difficulty breathing. My BP and heart rate are higher than I'd like but not particularly dangerous, and they're steadily decreasing. I get regular checkups. I'm not as quick as a smaller person, but then again I could pick that small person up and break him, or just kick his knee backwards.

    So really the only problem is the extra fat, but fat per se does not make you unhealthy. It has been associated with medical problems, but the studies to date have done a poor job differentiating between medical problems caused by fat per se and those caused by inactivity and bad diets. Moreover a study is looking at patterns, it says nothing about any particular person. The biggest direct problem appears to be pressure on the joints, and that's the main reason I'm losing the extra pounds. Also because of my left knee injury, which is mainly what caused me to put on weight in the first place.

    I'm not disputing that I need to lose weight. I'm saying that I am healthy now even though according to the BMI number I'm "morbidly obese." You would never look at me and call me thin. I'm a mountain with enormous leg muscles. But nobody would see me and think "gosh he's about to die from his fat." Nor would they ever imagine how much I actually weigh. I'm not a person who develops a beer belly. My fat is evenly distributed. None of this is taken into account on the BMI, which is why it's utterly useless as anything but an arbitrary statistical tool.
    The BMI scale is simply set as a ratio of weight to height and patient outcomes are placed onto it. As BMI goes up, adverse outcomes, supposedly due to excess fat/lack of activity/bad diet, also increase. You seem to be saying that we lack sufficient data to pinpoint why high BMI is correlated with bad health. I don't know the answer to that myself. Maybe it is the inactivity, but are you willing to risk your health because we can't show that it's actually the extra fat causing health problems?

    You may be the one outlier whose 160lbs (guessing) is not causing him any health problems, at least for now. Calling the scale useless for an individual, I believe, is a bit short sighted. The only way we can organize knowledge regarding weight and health is by generalizing from large fields of data, drawing conclusions, and applying those conclusions to individuals. And in general, people with high BMI's, like 48, have a lot of health problems. Hopefully we are finding our way in the right direction and are making good recommendations for people to lose weight to be healthy.

    I think where you are really trying to trick yourself is the area of health problems that you cannot see, or which you haven't been tested for yet: atherosclerosis of coronary arteries, fatty liver disease, insulin resistance, GERD (leading to esophageal cancer), as well as all the cancers that are associated with obesity:
    * Colon and rectum
    * Liver
    * Gallbladder
    * Pancreas
    * Kidney
    * Non-Hodgkin lymphoma
    * Multiple myeloma

    You could be facing a lot of health problems other than osteoarthritis. But then again you may be the person for whom the data doesn't fit, and you'll live to be 120 and never have any problems.

  17. #17
    Biscuit Boy Cosmoline's Avatar
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    And I could have a brain tumor or any number of other conditions. Who knows? The point is very simple--BMI is NOT and WAS NEVER INTENDED TO BE a diagnostic tool. The number literally tells you NOTHING about an individual other than giving a very crude and outdated idea of where they fit on a height/Weight chart. It's used by sloppy doctors who don't want to take the time to actually run proper tests to determine the health of an individual.

    And in general, people with high BMI's, like 48, have a lot of health problems.
    Well I don't. I have none, in fact. Not even HBP anymore. "In general" is not a diagnosis. Moreover because BMI has been used as the basis for so many studies, there's no way to tell whether the results are actually based on increased FAT or on simply being lazy.

    BMI doesn't even tell you how obese a person is! As noted, the lines are drawn based on Belgian body types from over a century and a half ago! If you want to actually see how much extra fat a person is carrying around, you must dunk them in a tank and weigh the fat. I realize that's time consuming, but unless and until there's a study done that actually determines how much fat participants are actually carrying we really won't be able to say anything for sure. On top of all this, the studies have not actually looked at the fat. It's not all created equal.
    ''On a bicycle you're not insulated. You're in contact with the landscape and all manner of people you'd never meet if you were in a car. A fat man on a bicycle is nobody's enemy.''

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  18. #18
    dolce far niente prxmid's Avatar
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    Cosmoline, I suppose I can relate. I had a BMI of 41 but otherwise great shape, low BP, low cholesterol, normal blood sugar, low resting heart rate.

    So I concluded the statistics didn't apply to me (and hopefully they don't) but the numbers still say you have an astronomically high chance of not living to your normal life expectancy, and a very good chance of developing diabetes (at least).

    It's like Las Vegas, in the end, the house always wins. Some people come away winners in the long run (I've yet to meet them) but the GREAT majority don't beat the odds. Is it worth it?

    I've heard the call and have lost 40 Lbs, working towards another 30.

  19. #19
    Biscuit Boy Cosmoline's Avatar
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    the numbers still say
    The numbers say absolutely nothing about *ME* because they are not about *ME*, they are statistical guesswork that at most shows a correlation between high BMI and other conditions. Medical science has not show a causal link between fat per se and anything except perhaps joint problems. Nor have very many studies been done on people who carry extra fat but are nevertheless active and in good health. Being overweight is entirely natural if you eat too much. In that sense it is not like smoking at all, though the gurus of the medico-diet industry want us to believe it is. We are designed to put on fat. What we are not designed to do is sit around for the entire day doing nothing and eating horrific foods.

    To be meaningful, a study needs to look at more than unrelated survey results from the 70's and run the numbers against a BMI chart, as many do. It must track actual individuals in a group over their lives. It must examine what they eat, how they eat, and how much exercise they get. And it must weigh their fat vs. lean mass. Further it should look at the interplay between fat and lean mass, and look at the fat itself. Is it brown or white, and what purpose is it serving? None of this has been done yet. Indeed medical science has only just figured out we still have brown fat in adulthood, and that it may serve critical roles.

    Furthermore, even *IF* BMI were a legitimate tool for studying large groups (highly questionable since it does nothing to rule out a myriad of other factors or body types), it STILL has no application as a diagnostic tool.

    I'm absolutely fed up with the idea that weight loss must be the top priority because of a number on a 150 year old chart. That's NONSENSE. It leads to fad diets and barbaric surgery. I've been down that road over and over again to no avail. The endless (and well documented) cycle of such dieting failure is sadly a near-universal phenomenon. What works is to concentrate on getting intense sustained exercise at least five times a week and cooking all your own food. At least that's been working for me. I dropped another ten lbs. in the past month, but I don't care one way or the other about that. It's much more important that I can last longer on the trails and climb higher.

    I'm just a big guy. I always have been and always will be.
    Last edited by Cosmoline; 05-12-09 at 12:46 AM.
    ''On a bicycle you're not insulated. You're in contact with the landscape and all manner of people you'd never meet if you were in a car. A fat man on a bicycle is nobody's enemy.''

    Tom Vernon.

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    Like others on here I'm not a real small guy but not big, big either. 6'1" and 225lbs. I hate typing that because recently I was at 218lbs but lapsed on my plan. I really pay no attention to BMI and have no idea what mine is. What I do now thou are two simple facts that are driving me to loose tha wieght. One, easier to climb the big hills and two....and please take no offence, how many old fat guys do you know. I think as long as you are comfortable and happy with were you are than good for you , you sir have made it!
    Best thing about cycling is when I'm at work I'm thinking of cycling, when I'm cycling I'm thinking about cycling.

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    dolce far niente prxmid's Avatar
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    Youcoming, that's enough empirical data for me. "There are no old fat guys".

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    member. heh. lambo_vt's Avatar
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    Sure, BMI is just a statistical tool, but someone 6 feet tall with a BMI of 48 is going to weigh 350 lb. Ignoring BMI for a second, someone (that's not a powerlifter) at 6' and 350 lb is going to have a high body fat percentage, which also correlates to a number of health concerns.

    Anyone is entitled to disregard BMI, and I agree it's not a particularly useful number. However, if your body fat percentage is high the "average person" is still at risk. OP, it sounds like you're claiming you're a corner case, but that doesn't invalidate metrics like BMI and body fat percentage for people that aren't you.

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    Biscuit Boy Cosmoline's Avatar
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    It invalidates BMI as a diagnostic tool, because it has no application to any particular person. Even assuming BMI is an accurate representation of average modern Americans instead of early 19th century Belgians, *no* particular patient is an "average modern American." Each is unique. The chart was absolutely never intended to be used to diagnose problems and recommend surgery or dramatic weight loss programs. However that's exactly what lazy doctors and nutritionists have been using it for. The doctors must determine actual fat percentage, nutrition, exercise and most of all run tests on the core systems in order to offer meaningful advice. Of course this costs money and takes time, so most of them just skip it.

    What concerns me most is that these raw figures are used to get people to take very drastic measures such as surgery or radical dieting. In some cases I have no doubt that this is the only option. A smaller person with my bulk on him would be crippled. But in my case such measures are patently absurd given my activity level and general health. They would do far more harm to me than the extra energy stored as fat. BMI does not distinguish between the cases, it assumes everyone is basically the same. That's why it should never be used in diagnosis.

    Here's a classic example from one of the "lap band" mills:

    Calculate your BMI

    Find out if Bariatric Surgery is right for you.
    Bariatric surgery is most appropriate for people with a Body Mass Index (BMI) of 40 or more, or 35 or more and experiencing obesity-related health conditions, such as high blood pressure or diabetes and who also might have serious health complications related to obesity.
    http://www.urmc.rochester.edu/hh/ser...rs/bariatrics/

    So hey, I'm over 40 so off I go to have some jerk saw up my beloved gut. It's madness.
    Last edited by Cosmoline; 05-12-09 at 09:58 AM.
    ''On a bicycle you're not insulated. You're in contact with the landscape and all manner of people you'd never meet if you were in a car. A fat man on a bicycle is nobody's enemy.''

    Tom Vernon.

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    Senior Member Wogster's Avatar
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    Quote Originally Posted by Cosmoline View Post
    It invalidates BMI as a diagnostic tool, because it has no application to any particular person. Even assuming BMI is an accurate representation of average modern Americans instead of early 19th century Belgians, *no* particular patient is an "average modern American." Each is unique. The chart was absolutely never intended to be used to diagnose problems and recommend surgery or dramatic weight loss programs. However that's exactly what lazy doctors and nutritionists have been using it for. The doctors must determine actual fat percentage, nutrition, exercise and most of all run tests on the core systems in order to offer meaningful advice. Of course this costs money and takes time, so most of them just skip it.

    What concerns me most is that these raw figures are used to get people to take very drastic measures such as surgery or radical dieting. In some cases I have no doubt that this is the only option. A smaller person with my bulk on him would be crippled. But in my case such measures are patently absurd given my activity level and general health. They would do far more harm to me than the extra energy stored as fat. BMI does not distinguish between the cases, it assumes everyone is basically the same. That's why it should never be used in diagnosis.

    Here's a classic example from one of the "lap band" mills:

    http://www.urmc.rochester.edu/hh/ser...rs/bariatrics/

    So hey, I'm over 40 so off I go to have some jerk saw up my beloved gut. It's madness.
    BMI is like that funny clunk the car makes when you put it in reverse, it's an indicator that there is an issue that may need further investigation. Looking toward your feet and not being able to tell what colour shoes your wearing, because there is a spare tire big enough to fit a city bus in the way, is another indicator of the same thing. The person is likely overweight, and further investigation needs to be done to determine if that condition is affecting their health conditions. Even at my heaviest (260lbs, 5'9½") I had a blood pressure that was a low normal, a cholesterol that was pretty much at the mean, and a blood sugar that was pretty much dead centre of what it should be. That left me with a BMI of 37.8 , but I was tired and sluggish all the time, changed from a desk job to a labour job, and lost about 40lbs, got back on the bike (first time in 20 years) and dropped to about 205, yeah dropped from obese to just overweight. Then of course along comes winter and I put about 20lbs back on.....

    BMI's primary use is so that life insurance brokers can set rates. They ask for height and weight, and plug in to a calculator to get BMI and look up rates. This is all based on averages. Life Insurance is based on the chance a given individual will die during the term of the policy, insurance companies must therefore set rates so that payouts are less then income. A 45 year old man, with a BMI of 40 is more likely to have health issues then a 45 year old man with a BMI of 25, so they pay a higher rate. This doesn't take into account actual individual health, because it's all based on averages. One of the health issues that we often don't see mentioned here, is that some overweight people are depressed, so the chance of them committing suicide is higher, and not all suicides are obvious.

    The lapband place is using it as a filter, under 35 you can probably lose the weight yourself if you work at it, over 40, they are assuming you probably can't
    again though it's the law of averages, if 100 people with a BMI of 40 try to lose enough weight to end up with a BMI in the normal range, on their own, somewhere between 60 and 95 will fail, and probably have, several times before.

  25. #25
    Biscuit Boy Cosmoline's Avatar
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    BMI is like that funny clunk the car makes when you put it in reverse, it's an indicator that there is an issue that may need further investigation.
    Actually BMI would be like looking at your mileage and comparing it to a generic car mileage chart that purported to tell you when your car was going to conk out. Regardless of make, model or year. That information would be virtually worthless for a mechanic, since one car with good service may be perfectly fine at 150,000 miles while another will be ready for the junk yard.

    Even more, BMI would be like comparing your mileage chart to a car mileage chart made in Europe during the early days of automobiles.

    Looking toward your feet and not being able to tell what colour shoes your wearing, because there is a spare tire big enough to fit a city bus in the way, is another indicator of the same thing.
    No, it isn't. BMI does not tell you how big your gut is. I've never lost sight of my shoes in spite of my high BMI.
    ''On a bicycle you're not insulated. You're in contact with the landscape and all manner of people you'd never meet if you were in a car. A fat man on a bicycle is nobody's enemy.''

    Tom Vernon.

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