54 million ‘obese’ Americans wrongly labeled as unhealthy

Remember how Jack used to call Will fat even though he really wasn’t? The same might be said of more than 54 million Americans categorized as obese and unhealthy based on their body mass index (BMI). A new UCLA study published in the International Journal of Obesity found that 47.4% of Americans (34.4 million) who are deemed overweight according to the BMIs are actually healthy – and the same applies to 19.8 million who are considered obese. “Many people see obesity as a death sentence,” assistant professor of psychology in the UCLA College, director of UCLA’s Dieting, Stress and Health laboratory, and lead author A. Janet Tomiyama said in a UCLA News Room release. “But the data show there are tens of millions of people who are overweight and obese and are perfectly healthy.”

Body mass index is measured by diving weight in kilograms by the square of height in meters. According to the CDC, an adult with a BMI below 18.5 is underweight; a BMI between 18.5 and 24.9 is considered normal or healthy weight; an adult with a body mass index ranging from 25.0 to 29.9 is overweight; and a BMI of 30.0 or higher is tantamount to obesity – the study stressed that normal BMI should not be the main goal for good health, though. But BMI involves more than just kilograms and meters; it also has a lot do to with dollars and cents. Many companies use BMIs to determine whether their employees’ healthcare costs. Additionally, people’s health insurance premiums could be in direct proportion to their BMIs should a rule proposed in April by the Equal Employment Opportunity Commission – which would allow employers to charge higher insurance rates to people with BMIs 25 or higher be – adopted.

UCLA psychologists used data from the most recent National Health and Nutrition Examination Survey to examine the relationship between BMI and a number of health markers such as blood pressure and glucose, cholesterol and triglyceride levels. They found that the millions of people considered either overweight or obese – and therefore unhealthy – would be likely to incur higher medical costs if their health readings are based solely on their body mass indexes. However, taking into account other factors, it would not be fair to burden them with increased healthcare premiums. Other findings include the following:

·         More than 30% (about 20.7 million) of people with BMIs in the ‘normal’ range are actually unhealthy based on their other health data.

·         More than 2 million people considered ‘very obese’ due to having a BMI of 35 or higher are actually healthy; i.e., about 15% of Americans who are classified as very obese.

“There are healthy people who could be penalized based on a faulty health measure, while the unhealthy people of normal weight will fly under the radar and won’t get charged more for their health insurance,” Tomiyama said. “Employers, policy makers and insurance companies should focus on actual health markers.” She found that prior research did not show a clear link between weight loss and health improvements in relation to hypertension, diabetes, and cholesterol and blood glucose levels. Doctoral candidate at UC Santa Barbara and study co-author Jeffrey Hunger said the research “should be the final nail in the coffin for BMI” as a health measure. He favors eating healthily and exercising as opposed to becoming obsessed with weight, and is against ‘fat-shaming’ people. Tomiyama plans to follow up with a study of people with high BMIs who are otherwise quite healthy.

Related: Can people be healthy and obese?