Should race affect BMI guidelines? Doctors are split
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What is the main topic discussed in this episode?
I haven't seen my son since 2012.
This is Deborah Tice. The disappearance of her son Austin is one of the biggest missing person cases in the world. What do you want from me? I should solve the mystery.
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You're listening to Short Wave. From NPR. You're walking into your doctor's office for your annual checkup. You probably fill out a form or two. Then your doctor starts going down a checklist, taking your temperature, blood pressure, height, and weight. These last two are used to figure out your body mass index, or BMI, the bane of many people's existence. That's used to determine your risk for a whole bunch of dangerous common health conditions like heart disease and type 2 diabetes. And okay, that's probably not news to you, but you know what was news to me? BMI was never intended for medical use.
This is a roughly 200-year-old metric that was invented by honestly some random scientist dude who was European, and his goal was not to invent, like, oh, this is gonna be the ultimate medical measure to define. overweight or obesity or give people a a diagnostic or screening tool. No, he truly just wanted to look at the people around him and determine the characteristics of the ideal form. And because it was, you know, the 1830s, it was like the ideal white male form.
That's Katie Wu. She's a staff writer at The Atlantic who looked into BMI. And why, despite this origin story, researchers still found it useful. And over time it became a blunt way of lumping people into four groups obese, overweight, healthy weight, and underweight.
And that is still essentially the categorization system we have in place today.
Why do doctors still rely on BMI despite its limitations?
You can go on the C D C's website, uh the World Health Organization's website, the cutoffs are pretty similar. And for the most part, it's quite universal.
And that's the issue a lot of regular people and doctors today have with BMI because people are really varied.
I think anytime you try and apply some sort of universal categorization metric to an entire species with billions and billions of people from all around the globe. uh where there are different sexes, different genders, different cultures, uh different heritages, different people with different muscle mass, different lifestyles. It's not gonna work.
It's complicated.
There are people with, you know, quote unquote high or overweight or obese BMIs who are extremely healthy. Many
athletes are a classic example.
And conversely, plenty of people in the technically healthy weight category who are experiencing all sorts of metabolic issues.
And that has issues. Research suggests that certain racial groups have been underscreened for type two diabetes. So why haven't doctors just scrapped it for something better?
It is simple and easy. I mean it is something that factors in height and weight. These are in everyone's chart. A lot of doctors can't imagine their practice without it. But so much goes on beneath the surface and BMI doesn't account for most of it.
And in an attempt to change that, experts have started considering another factor when deciding BMI cutoffs. Race. So today on the show, what led to race-specific BMI cutoffs, the pushback against it, and whether we should be using BMI in medicine at all? I'm Regina Barber, and you're listening to Shortwave, the science podcast from NPR.
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Chapters
6 chapters
1
What is the main topic discussed in this episode?
0:00–2:03
2
Why do doctors still rely on BMI despite its limitations?
2:03–5:32
3
How was the original BMI formula created and what biases does it contain?
5:32–8:28
4
What evidence shows that BMI misclassifies health risk for different populations?
8:28–11:12
5
Why are Asian American and Pacific Islander groups screened at a lower BMI cutoff?
11:12–13:38
6
How does visceral fat differ across ethnic groups and affect diabetes risk?
13:38–15:40
Speakers
6 identifiedMore from Short Wave
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