Weighing the Truth: BMI and the Debunking of 'Healthy Obesity' Myth
Hey, Athletes! Weighing the Truth: BMI and the Debunking of 'Healthy Obesity' Myth
IN THIS 48-MINUTE EPISODE WE DISCUSS:
- Jerred and Joe talk BMI
- They go through a study on metabolic health
- They give their own thoughts on BMI
- And A LOT MORE!!
If you want to go a little bit deeper on this episode, here are some links for you:
Reference this study for this week!
Garage Gym Athlete Workout of the Week
Don't forget to watch today's podcast!
Thanks for listening to the podcast, and if you have any questions be sure to add it to the comments below!
To becoming better!
Joe: [00:00:00] Welcome to the garage gym athlete podcast, where we talk about fitness, health and anything to help you become the most optimal human beings. Let's dive into it.
Jerred: Ladies and gentlemen, welcome to the garage gym athlete podcast. Jared Moon here with Joe Courtney. What's up, Joe?
Joe: Not much, man. What's going on with you?
Jerred: Not a lot talking about BMI today. So we're gonna dive into whether or not BMI is a reliable health metric based off of this new study that we just found and Cool question I think that came out of it is can you be obese and still be healthy?
Because that gets thrown a lot around of like these days where we're like, it's okay to be overweight I'm not saying it's not okay like You do whatever you want, but are you healthy? That's an objective metric, not a, is it okay? Are you comfortable with your weight? Like, is your weight actually okay for your health?
So that's what we're diving [00:01:00] into today.
Joe: My quick question is, are you overweight?
Jerred: Me? Uh, well, we can dive into that. And I do have, there's some stuff that we'll get into with BMI. Um, Because there's, there's pros and cons, right? Like, I, I realized that going into this study is like, my own personal feelings of BMI may not matter compared to how large this study is, right?
Because there's not, uh, not to sound egocentric, but there's not a lot of me's walking around. There's a lot less of me's walking around than there are standard, I don't ever exercise people, right? Um, but let's dive into it. The study is called... Metabolically healthy, healthy obesity is a misnomer.
Components of the metabolic syndrome linearly, linearly increase with BMI as a function of age and gender. This was done in May of 2023. So big study, it was in Israel. Um, and what they were looking at, they wanted [00:02:00] to explore the relationship between BMI and metabolic syndrome components. So the researchers drew a facet blood sample and measured height, weight, waist circumference and blood pressure for each participant.
The researchers then calculate the number of metabolic syndrome components each participant had based on the results of their health screening. Um, and they assess metabolic syndrome components as the following. So we've talked about metabolic syndrome. Um, basically, if you have any of these different Metabolic syndrome components, um, you're considered to, you know, not, not be as healthy, healthy essentially.
And when I talk about fat burning in zone two, we talk about metabolic syndrome and how people with metabolic syndrome typically burn carbohydrates faster. They have a very hard time burning fat. Metabolic syndrome to me is really, your system is just not working very well, like you're Body system is not working very well, and you can do things to improve it.
But the four components they were looking at to [00:03:00] classify metabolic syndrome were elevated triglycerides, uh, so greater than 150, low HDL C, so less than 40 milligrams per deciliter for males. And less than 50 for females elevated fasting plasma glucose of greater than 110 milligrams per deciliter or a diabetes diagnosis.
And the last 1 was high blood pressure, high blood pressure, which they were rating as systolic blood pressure greater than 130 or diastolic. Blood pressure greater than 85. Um, and then they also looked at waist circumference. So their cutoffs were, if they were looking at the American U. S. adult treatment panel, um, greater than 102, 102 centimeters, which is 40.
16 inches for males and greater than 88 centimeters for females or 34. 65 inches. Uh, so. That is what we're looking at. Um, they were [00:04:00] basically had this massive study. So the researchers enrolled a total of 19, 238 healthy adult participants who are undergoing periodic health checkups at the medical center.
So they would just go in and checking all these different things and trying to see, answer these questions of like, can you be. Healthy and be obese. And can you, uh, you know, what are, what is the correlation between health and, and B M I and all these kind of things. Uh, but let's talk about B m I for a second.
So you opened with a question, Joe. Am I obese? So overweight, you can go online or am I overweight? Uh, am I obese? So, um, you can go online to these B m I calculators, right? And check things out. So I'm gonna enter it in. Um, I did mine
Jerred: because I was curious. Yeah, I entered in too, but now it looks like it's reset itself, but it won't take me but a second.
Um, so what's your BMI? Mine, uh,
Joe: 27, most of them gave
Jerred: me. Yeah, mine's 26. 5, uh, which puts me in the [00:05:00] overweight category for sure. Uh, and in, let's see, college, right out of college, I was like 22. I was 5'11 and the heaviest I got, I was 215. I think and I'm right on the obesity line, so I have been obese and I have been overweight, um, in all these different categories.
So you can go on these calculators and check them out and see where you're at. Uh, so how do you, let's just start with our personal feelings of BMI before we dive back into the science and the takeaway from this study. Like, Okay. What do you think about BMI in general as a, as a metric for health?
Joe: Uh, pretty awful.
I think it could be like a first step, like, okay, here, like if you're, if you're filling out a doctor's form or a, some sort of application, whatever the form is, and that might ask you for BMI and it goes, okay, according to these first step calculations. If you're overweight or obese, maybe especially obese now proceed to step two.
And let's see if you actually are [00:06:00] unhealthy, obese, or need some help. But if not, you know, if you're fit and shave, have a lot of lean mass, then, you know, this calculation is, is null and we'll just move on. So that's kind of my initial thought of it. Like there's plenty of times where, um, like an air force PT test or doctor's appointments where you, we, your BMI will be overweight with a lot of people.
We would have that. And it just means absolutely nothing, but they could also be. The first step indicator, uh, unless if, if you, um, don't display a lot of the normal, like lean mass and activity
Jerred: levels. Yeah. I would say I kind of have the same view until the study, to be honest, made me think BMI. It is a better indicator for health, but you kind of have to throw out the, if you're muscular, that's I mean, that's the only real problem with BMI most fit people or muscular people have a problem with is like, it's heavily based off of weight.
And so, you know, weight and [00:07:00] age. And so if you have like a lot of muscle mass, you're going to weigh more, right. Just because of how dense muscle is. And even right now, you know, my BMI is sitting in the overweight category. In fact, I would have to lose. 15 pounds to go just to click into the normal weight.
And I'm, I don't want to lose 15 pounds at all. Um, I mean, I, I feel like I could probably lose 10 right now and be okay, but I wouldn't want to go any lower than that. Like I'd actually feel like lean mass. Yeah. Like, I feel like I'd be like, okay, this is, this is aggressive. Cut for me. I don't know if I want to continue.
So something just to factor in, before we dive into more of the science, if you're out there, and you do one of these calculators, and you are a more muscular individual, I would just go off of the blood work. So I talked about in the beginning, like triglycerides, HDL, elevated fasting glucose, high blood pressure, [00:08:00] Those are the things that you should look at, independent of your, uh, BMI.
And so that's just, uh, for all the healthy, muscular athletes out there listening, that's one thing. But, when you actually look at the science, and this isn't like a study of 17 people, right? This is 19, 000, over 19, 000. People in this study and here were a lot of their their takeaways I'm gonna start with one that I thought was pretty interesting and it's that metabolically healthy Obesity is rare in subjects with a high BMI in declines with age.
So it is very rare To be, have a high BMI and still everything be okay. You have like zero symptoms. There's zero indicators of metabolic syndrome. And it said, if you break down to the percentages, only 7. 5 percent of participants with a BMI of 30 or higher, and just so we know the range is. [00:09:00] Less than 16 is severe thinness and greater than 40 is obesity class 3.
So, if they're at 30 or higher, only 7. 5 percent of participants with a BMI of 30 or higher were metabolically healthy but also obese, right, in that category of obesity. And then only 1 percent of participants with a BMI of 36 or higher, so you're going into like the extreme areas of obesity, only 1 percent of those people...
We're metabolically healthy with that large of a BMI. And this is where I think, this is where I think obesity starts to play out is at the extremes. Because I could, I won't get any taller, right? But I could gain, let's, let me see how much I'd have to gain to go. Into, uh, like severe obesity. So, would I have to be two 50?[00:10:00]
Uh, two 70?
Joe: I don't think you could do it. .
Jerred: All right, let's, let's go to 2 95.
Okay. So if I'm 2 90, 2 95, that throws me into this max level of obesity. So for me, that's gaining. About a hundred pounds right now. No way, no way I could gain a hundred pounds other than being on like straight steroids, uh, and trying to gain muscle mass that way. So that, that's where I think BMI starts to play out in the middle.
It's a little weird because like I'm a little bit more muscular. So it puts me in the overweight category, but on the extremes, it's absolutely accurate because if I got to that level, I think that I would have a couple of different, uh, Syndrome, metabolic syndrome components going on for sure. Uh, so that's one thing that's really interesting.
So this whole, like you can be overweight and be healthy is true, [00:11:00] but it's only true 7. 5 percent of the time, if you're at 30 or higher, and it's, you're a 1 percent or if you're completely healthy, no metabolic problems at all, 1 percent or if it's 36 or higher, but the fact that that exists is still pretty impressive to me.
So that it does exist. You can be. Severely overweight according to the BMI and still be healthy. It's a possibility, but not as common as you would think. Like, have you ever heard of the, the chronotypes with like people who are like, some people actually only need six hours of sleep and some people. Yeah, yeah, yeah, yeah.
And, uh, I think it was in the book why we sleep and he's like. It's like half of 1 percent of people are actually the one that needs like five or six hours of sleep. Everyone thinks they're that just because they want to sleep less, right, and do more. But it's very rare that you are actually that thing.
That's how I feel about this. It's like some people might be overweight and be like, no, I'm, I'm good. I'm healthy. It's like, well. The science [00:12:00] is only only 1 percent of people ever, you know, could be at a BMI of 36, 36 or higher and still be metabolically healthy. So you probably have something going on with with BMI.
Joe: It's funny like you, you kind of came away with this a little bit more pro BMI. And I came away with this thinking BMI needs more pushback and.
Jerred: I mean, what part of the study do you think gave you that that it needs more pushback? So
Joe: partially was and I mean, there's a lot of outside logic that I put into so for one Um, I I didn't know this until reading the study that the BMI was created by a mathematician not a physician Which is interesting.
I think BMI I think I think they need to refine the calculator more So right now it's just most calculators that I found was just height and weight. That's it No sex, no age. So I think they need to have, cause another thing that was a big factor that was mentioned in studies that age can be a huge factor with metabolic syndrome.
So you could take [00:13:00] the, you know, 290 pound 25 year old and compare it to a 290 pound 45 year old. And one might have zero to one metabolic syndrome. The other one might have three or more. So the calculator. I think needs to be refined, um, a bit more, maybe even a waist measurement. They mentioned the waist measurement for like a maximum, whatever it was.
So I think that needs to be improved because there was also, um, you did mention that, okay, at BMI 30, only 7 percent of people had zero, um, metabolic syndromes. Okay, cool. But only 19 percent had three or more. It would actually had had like the obese metabolic syndrome. So that is like the actual real.
Unhealthy, like you need to, you need to be seen and fix some stuff because you have three or more of these things. That's only one fifth of people that are obese. So to me, one fifth, isn't like defining while there is correlation with all of this BMI
Jerred: and that's one fifth at three or more. I mean, that's 75 percent as get like.
If you [00:14:00] get to four, you're as unhealthy as you can possibly
Joe: be. Oh, oh yeah, a hundred percent. So it was just, I, I just felt like there was, there's a lot more, uh, factors and I think there's needs to be a bit more pushback because, and my brain is also goes to how something like the military operates and how they, they could just use your height and weight and go, oh, hey, you are, um, You're, you're overweight or you're obese.
We, you need to, you need to, uh, you need to fix this. You need to do that and this, that, and the other. Um, I'm wondering if like outside health insurance would, if your BMI is like overweight or obese, but you're actually healthy and fit, they don't take anything into effect, they could charge you more because you are technically overweight or obese, I could see that being a, being an issue.
So there's all these other things that, you know, because there's not enough pushback on BMI, because people are like, well. It's not perfect, but see, it kind of correlates. So it's kind of okay. So it mostly makes sense since there's not enough pushback. I feel like it could be accepted more and therefore there could be repercussions for, for another, a different number of degrees.
[00:15:00] So I just think the BMI needs to be better, better refined, more, more calculated, more factored into. And then, like I said, in the beginning that. It's, it's a good first step so that if you see a 28, a 29 or a 30 and you, uh, and then you might have either, um, high blood pressure or something, then you go, okay, well, now we need to do a full blood panel and see how unhealthy you actually are because you're not optimal.
So let's go to the next step instead of just taking the BMI
Jerred: as fact. Yeah, it's a fine line for me, like on the individual basis, I think BMI is, is useless, uh, because. We're gonna look at blood, we're gonna look at muscle mass, all these other kind of things, but I do think the correlation between large data samples starts to tell a different story, and that's kind of what I picked up out of this, because what I don't like for people to do is like, say we just say BMI [00:16:00] is shit, and you shouldn't use it, right?
Well, that's not necessarily true. You know what I mean? Like, if you're sitting in the overweight or obese BMI category, And you're not 11 percent body fat, you might have a problem. You know what I mean? Like I don't want people, I don't want to let people off the hook thinking that no, it's okay to be in these obese, these overweight and are obese categories because BMI is bullshit when it's not really bullshit.
It's only bullshit. If all your blood markers say it's bullshit and you're really like high, like high muscle mass, low body fat. Because if you, if you are like 30 percent body fat and your BMI is high, Now you're just playing into the BMI metrics. You know what I mean? You're just like, you are that you are why BMI was like created and why it's uses correlative data.
And so I think I'm kind of in both camps of like, BMI is useless at the individual level. If you know all these other things to be [00:17:00] true, if you like, you know what your blood blood is, you know what your muscle mass is, but it's very indicative on a large scale. Like I see why the military uses it. Um, in the military, like I would be overweight.
Every time I would, they would do BMI for me, but they had like a backup for that, right? They would tape your waist because I still have a small waist being overweight Which bring would bring me back down to the normal category But then again if you're like, okay, well BMI is bullshit and I'm in the overweight category I'm 25 30 percent body fat and my waist circumference is too big You don't have a leg to stand on.
You probably should lose some weight. You know what I mean? Like, I think that's, that's where I I'm kind of in both camps of like, if all your shit's not locked up on the side of. Then BMI might be a good indicator that you are headed in the wrong direction. Yeah,
Joe: true. And then there's always the people that we [00:18:00] know that are skinny fat, who just kind of throw the whole equation out because they are truly unhealthy, but their BMI
Jerred: one wouldn't show it.
They mentioned that too. I don't know where, if I'll be able to pull it up quickly, but it was something like people with a BMI below 19, I think it was, which is like super, like pretty. I think that puts you in the thin category. Not even, Oh no, I think I put you in the normal category even, but like they had P people with BMI of 19, there was still like a certain percentage of them that had, um, Metabolic syndrome.
Joe: Yeah. It almost started a, uh, a U shape cause like after, after 19, it started to go up on more, one or more, uh, metabolic syndrome components.
Jerred: Yeah, so that's what kind of interesting and so to your point You can still be you can be unhealthy. You can be healthy on the fringes like you can be Over 36, 1 percent of you would be, [00:19:00] would still be healthy, but then at the low end, you can have like a perfect BMI, like, and still have two or three, uh, metabolic syndrome components and be unhealthy.
So I am in agreement with you that it's not a great indicator of health, unless you're trying to look at like. Large sample size data because the only thing that I kind of pull out of it from like, okay What can we use with this is that? Yeah, if you get if you get overweight, you're gonna have health problems That seems like what the if I had to just sum up this whole study into like a correlation sentence It's like yep being overweight seems to correlate with Eventually getting sick or having some sort of metabolic disease I think the other stud the other takeaways Their main takeaway was metabolic syndrome components increase linearly with BMI from the lowest normal BMI and continues to increase with age and BMI.
And I think that makes sense too [00:20:00] because if you're 70 years old and you have a high BMI, The chance of you walking around just like a jacked grandpa and having all this muscle mass probably fading away, right? That's probably not why your BMI is high. Your BMI is probably high because you're just getting overweight.
So I think that that's that's something to look into and then their other stuff were just Kind of like throwaway takeaways. They talked about hypertension is most common in men Uh women had like more protective They it was okay for women to be overweight And their metabolic health be better, I guess, is the easiest way to sum that up, like, over time, is that what, how you took that?
Joe: Uh, it said that, like, theirs was just belly fat or what it, what their first indicator was or something like that, right? Midsection fat?
Jerred: Yeah, yeah, so women could have, like, a higher, like, uh, waist circumference or higher body fat and still be healthy. Uh, more, more prevalence [00:21:00] than men. I guess the way to put it.
So yeah, that that's basically everything from BMI. Will I start using BMI as a metric to gauge my health on a weekly, monthly or annual basis? No. The only times I ever calculate BMI were anytime I was in the air force, probably. And this is probably the most recent I haven't, I haven't looked at BMI. So no, it's not something I track or will ever track or find important.
Um, but like I said, the ultimate takeaway is. If you're gaining weight, you're probably headed in the wrong direction to some degree.
Joe: But I do, I guess like your point on the looking at the masses versus individual, it is kind of, I guess, somewhat indicative that way.
Jerred: Oh yeah. I think, I mean, I think that there,[00:22:00]
there are ways that the data can be used against you. Like I do, I don't actually know, like I've done a lot of life insurance exams, uh, over the last couple of years. And sometimes in different companies, I'm not like at their. Their top standard like I'm not like I'm like one notch below Like they're golden elite.
Right. And I'm like, how's that possible? Like, I'll see my blood, like they, they take blood for, uh, for all of these life insurance, insurance exams. And I'm like, though, all those markers look good. Don't smoke. Haven't smoked good family history. I'm like, what, what's knocking me down? And you know what it probably is.
Is BMI like, well, he's slightly overweight, so we're going to knock him down just a little
Joe: bit or just make that tier unattainable. Like, you think you could get better, like, you think they have a good top slot, but they just don't, or,
Jerred: or, yeah, or maybe it's just not even actually possible. Um, but no, I think my buddy got the top [00:23:00] spot, but he's just.
You know, whatever, two inches taller than me and like 40 pounds less than me. You know, it's like, okay, that's, that's what we want. Yeah, you need to be really tall and really skinny and you nailed it on the health side. So you're right in areas like that. That's probably why. And same with the air force. Um, would they, would they tape you in the air force?
Is that what they
Joe: do? I think they've stopped doing it for standard PT tests each time. Uh, the last one I did, they didn't, I think. I got taped two times ago, uh, because my BMI was higher. I don't know if it was because of that or if they were just, they were just still kind of doing it, but it's, it's stopped doing it every single time.
I know I should have asked Liz before I started. I know in Navy, she said that if their BMI is a certain thing, then they have to do a waist measurement and they might even do like a fat fold pinch thing. So I think they have that extra, extra
Jerred: step. Yeah. [00:24:00] If you're not in the military, you'll probably never really encounter BMI.
Other than maybe listening to this podcast and using a calculator for fun After you listen to this podcast to see where you're at Uh, but I mean that that pretty much sums it up everything bmi related I don't have a lot of takeaways for the garage gym athlete other than Pay attention to your weight.
It is a factor, but again, going back to everything being individualized, you could be one of the rare cases, the 7. 5 percent or the 1 percent or the 16%. So get regular blood work. Uh, typically I think at least once a year, maybe twice a year, check out all of, uh, the typical metrics that you have on, on blood work side.
Uh, you know, maybe look at your BMI, your weight, whatever it is. And, uh, the biggest thing I think the athletes need to pay attention to is just don't let anything creep up on you. This kind of happened to me recently when I was injured. I, uh, I think... Apple, Apple talks to [00:25:00] Garmin somehow, and Apple will give you trends, right?
They'll, they'll, Apple health will give you a trend. And so all my Garmin data was fed into there. And one day I hadn't checked Apple health in forever. And like, I opened it up and it was like something like your. Your activity level is down and has been down for like the last six months. And it was basically basing it off of my like step count, but my step count was like super low because when I was injured, I couldn't run, I couldn't do anything.
Um, I was just basically doing garage workouts for like strength stuff and kettlebell swings and like trying to do some conditioning on like a skier or whatever, but it gave me a low step count. And then I was also like, my weight was a little bit higher than I wanted it to be. I mean just by a couple pounds and I'm like this is probably if I didn't pay attention to this stuff I could see this forecasting out over five years and I would be 15 pounds heavier than I want and [00:26:00] not realize what was happening And so I think pay attention to trends like that over time as opposed to just your weight But like are you getting enough steps in every day?
Are you tracking your workouts? Are you getting enough workouts in all of those kind of things? I think if you can maintain all of that doing your blood work once a year Uh, you know, getting enough movement in every day again, you know, I'm not big on steps, but steps, I think, are a good indicator of like your general activity in a day.
Um, if you have a watch, like I don't have a step goal, but it's cool to see, you know, how many steps you might get in a day between if you're running or walking or just moving a lot. Like I know I can not work out on a Saturday when we have like five games with the kids and I'll still get like 15, 000 steps that day.
No problem. Like, so I'm very active at this point in my life, even with, uh, just doing kids stuff, even if I don't train. So anyway, pay attention to all those things. My takeaway for the garage gym athlete, uh, might sound like a lot, but really just. Don't let age and, uh, inactivity creep up on you. [00:27:00]
Joe: Apple has a lot more health stuff than I realized.
I've never opened it up
Jerred: either. Yeah. I used to look at it when I had an Apple watch and then I stopped and then I know I linked Garmin and Apple health and then never looked at it again. And other than when they alerted me, you know, a while back.
Joe: And most people have sedentary, a lot of people have a sedentary job.
So like activity, just making, even, even if you work out every day, you could just sit around and do nothing the rest of the day. And it's still not helping you.
Jerred: Yeah. I had that day yesterday. I was like, I was doing a lot of, uh, at a lot of meetings and doing a lot of, uh, planning. And so I didn't move at all yesterday at all.
I finished the workday and I had 1600 steps and that's like, right when I was going to go work out. And so just for reference. I don't know what people should be getting, like probably 10, 000, right? Like, is that like a good metric for steps in a day? Um. I had 1600 steps and what's funny [00:28:00] though is I then worked out and then did all the kids stuff or whatever I probably ended the day at like 9, 000 or whatever, but my day was very inactive yesterday.
So typically I try to work in like walking, stretching. All those kinds of things, but it wasn't happening yesterday. It was just incredibly didn't do anything.
Joe: My steps are always hard to gauge for accuracy because like, I'm not even wearing my watch right now after I work out, I rinse it off, I take it off.
And then I just let it dry for a couple of hours. So I don't even wear it most of the day. Uh, but, uh, yeah, I have my standing desk that I try and at least stand for an hour or so.
Jerred: My watch is like surgically attached to me. I, I remove it to like charge it for like however long that takes, an hour, once a month, and then that's it.
Alright, we'll roll, we'll get out of here. Um... So all garage gym athletes out there. Uh, thank you so much for sticking around, for being a part of the [00:29:00] community. You guys are awesome. If you wanna be a part of the community, you can join. Go to garage gym athlete.com, sign up for a free trial. We would love to have you a lot of big stuff happening in q4, uh, this last quarter of 2023.
So stick around as we start announcing those things. But that's it for today. Remember, if you don't kill comfort, comfort will kill you.
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