Another Nail in the Coffin of BMI

In August I outlined some of our reasons for believing that the most common measure of overweight and obesity – the body mass index (BMI) – can be very misleading and should probably be abandoned, or at least consigned to the back burner.

A team at the Hammersmith Hospital in London led by Professor Jimmy Bell has been using a novel type of MRI scan to locate the distribution of fat in the body. The problem is that 40% of the population has "bad" fat around some of their internal organs including the heart, liver or pancreas, even though many appear thin. So even though they may look slim, they may still be at risk of conditions like insulin resistance, diabetes and hypertension because of this hidden fat.

As we have said before, from a health perspective, it is the distribution of fat that is all important, rather than just the amount of it. This study confirms what metabolic physicians have been saying for years: BMI gives you the wrong idea about how much fat you have.

Once you know about the distribution of your fat, we can design precise lifestyle changes to work on it. As an example, the strategies that we use for overall weight management are not the same as the strategies that we use for reducing intra-abdominal fat. There are very good physiological reasons why diet does little to reduce the fat around organs. It is there to provide fuel during exercise, so specific exercises are the way to rid yourself of this internal fat.

At the moment there are very few centers that can do this kind of scanning, but with the growing evidence of its importance, that is likely to change. In the meantime, be aware that aerobic exercise and strength training, particularly if it involves the large muscles of the back trunk and lower limbs is the quickest way to rid yourself of these dangerous fat deposits.

Fat in itself is essential for normal health, but fat in the wrong places can be a killer. And BMI tells you nothing about the fat lurking in the hidden parts of your anatomy.

Comments

[Atsuko Fritz]

This is my first time to read your blog. Very interesting information.

Are there any books or materials that I can learn more about fat at wrong places in the internal organs?

Are there any methods (diet, exercises, and others) to prevent and manage the wrong fat in the internal organs?

Thank you.

[Richard Petty]

Dear Atsuko Fritz,

I am delighted that you have found your way here: I post as much accurate and topical information as I can. (I check everything myself!).

There is a very large literature on different distributions of fat and what to do about the "bad" fat. If you follow some of the links on this site on weight management and insulin resistance, they should give you what you need.

If you need more, do please let me know. I can either post or email you a bibliography. EIther a couple of books, or else some original papers.

Kind regards,

RP