this post was submitted on 20 Aug 2024
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collapse of the old society
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Don't you mean weight? Forgive my ignorance but I'm pretty sure in the medical world BMI is literally what determines obesity.
It's only a rough guideline. There's Olympic athletes that would be considered overweight based on their BMI that are basically all muscle. It's a decent guideline for your average person, but there's outliers that don't fit in that scale. After all, you're making a judgment based on just 2 parameters.
So it's a decent guideline like you said, barring some extreme exceptions like olympic-level athletes which aren't a high percentage of the population.
Nah, its off in a lot more ways. Bone density, it exaggerates tall peoples "fat"ness, and short peoples "thin"ness, racial differences, differences between the sexes, so on and so forth.
Its a 200 year old formula that's extremely generic. There are newer ones that are better, like waist to height ratio, hip and height, body comp, etc. Each one of those has some flaws too, but the waist to height is apparently pretty damn accurate. Way more than BMI. But it doesn't work for certain ethnicities, children, or people with medical conditions that would enlarge their waist.
My workout partner in college was clinically obese based on his BMI. He was like 6% body fat and had more than average muscle mass but was not huge. He was built like Hugh Jackman as Wolverine except shorter. There's lots of guys like that. Not sure I'd consider them to be extreme exceptions.
I was considered obese by BMI standards in high school, when I was outside with friends riding bikes all day and phys ed at school where I lifted weights daily. I would be impossibly thin if I tried to achieve it now.
No, BMI is directly a function of weight.
Obesity is quantified using BMI by medical organizations because there isn't an effective way to quantify it otherwise, but it's in the same way as using IQ is a shorthand for intelligence or the DSM is used to describe mental illness. It needs a qualified professional to use the raw data point in combination with other factors in order to tell you if your body fat is actually unhealthy.
High body mass does also add its own strain independent of fat, but the actual intent of the term obesity is about whether you have a level of excess fat that lowers health outcomes, not size by itself. (It also wasn't actually ever intended by it's creator as a measure of health, just as the broad stroke data point it is.)
But the alternative to being high weight without high body fat % is high muscle mass, which is only a thing in a few humans.
IQ is indeed not representative of intelligence because we can't represent a lot of functions of intelligence in a sensible test.
The DSM is a list of diagnostic criteria. Hopefully patient-facing shrinks don't use "raw data" outside of said diagnostic criteria to make judgements on diagnoses, otherwise they're just using arbitrary non-spec information.
What other raw data is used in the weight example?
It's a thing in a good number of humans. Once you do pretty much any strength training (or just heavy lifting) at all, BMI loses its value pretty quickly. It's a rough indicator.
The DSM is definitely not intended to be stand alone. It is a set of general guidelines and definitions to inform the evaluation of a mental health professional. Most people check a good number of boxes on a good number of those checklists. The checklists are a tool to be used in collaboration with the professional judgement of the doctor. Almost every individual checkbox is "checked" or not based on the doctor's subjective evaluation.
Muscle mass and general body composition are part of it. Some people are naturally bigger and healthier at more weight than others. Some are naturally smaller and healthier at levels that would be unhealthy skinny for others. Presence of other obesity related illnesses are another. If you're showing signs of heart disease, breathing issues, etc, in addition to being big, that's a sign that losing weight will improve your health outcomes. BMI is a very rough yardstick that is used for the purpose of evaluating populations over time. It is not a good way to look at the health of a single individual without context.
So it seems like there's just an exception in the few gymrat type folks out there and athletes. Still seems like a small exception group compared to the general population. That aside, the bit about certain people being healthier while bigger/smaller seems anecdotal and unscientific afaik.
I don't think most people would check many boxes for schizophrenia or gender dysphoria or even ADHD, though as always the real test is whether the meds help.
As for GAD or something more unspecific it's really more about whether it impacts their life negatively or not which is a presumption under which those checklists are meant to be taken.
Still, I've never heard of someone checking off all the boxes while self-diagnosing and then going on to not be legitimately diagnosed outside of a few cases where supposed professionals usually apply some discrimination based on immutable characteristics.
Yeah this kind of just demonstrates that the doctor's part of the equation is utter bullshit
"Gym rats" means anyone who's ever played a sport. Or done a job with manual labor. Or did any of many other things. BMI is "unscientific as fuck". It was literally never intended to be used anything like how it's used. It was solely intended to give a broad strokes single number for size relative to height (in a very limited initial population). There is no actual basis for its use anywhere.
The entire DSM was designed for the sole purpose of being used by a doctor. It was never intended to be used to self diagnose, or in literally any context outside of being used by a professional. The doctor's part of the equation is the whole point and the only thing that makes the DSM useful in any way. It is not standalone. It is a tool to enable doctors to have a consistent framework and process to do their job.
But anyways, this is all way off topic.
The entire point is that treating very rough, loose yardsticks as the "truth" for complex phenomena is nonsense.