Dr. Madan Comments On Debate Over Accuracy of Using BMI in Measuring Obesity

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A current medical debate centers around whether or not obesity can be accurately measured via BMI. Dr. Madan indicates that BMI alone may not give a wholly accurate depiction of obesity, but that potential LAP-BAND® patients should not rule it out as one means of determining unnecessary weight.

The Weight is Over. Choose LapBand®

Obesity is a touchy topic at the best of times. One of the most common ways of identifying and distinguishing between overweight and obesity has been the body mass index (BMI) of a person, which is supposed to show the difference between a healthy range of weight and too much weight. A recent article published in the prestigious Journal of the American Medical Association (JAMA) sparked off many newspaper articles about how being overweight or even severely obese was not life-threatening. Bariatric surgeon Dr. Madan indicates that perceptions of this research may not have painted an accurate picture, and says that a BMI reading shouldn't be ruled out as a factor in determining obesity and appropriate measures for dealing with it.

The study that caused so much media furor was led by Katherine Flegal, from the US Centers for Disease Control and Prevention. This review of data mined from 97 studies related to almost 3 million people. Published in JAMA on January 2, 2013 (“Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories”), the study tried to determine whether BMI indexes for oveweight and various grades of obesity had a bad effect (or no effect) on overall health.

Although the study concluded that all grades of obesity did significantly contribute to mortality in general, the surprising feature was that an overweight BMI (25 – 30) seemed to show a noticeably lower risk of mortality. Also, those studied with grade 1 obesity (30 to 35) did not show a much higher mortality rate than those at a “healthy” BMI.

This may not be so surprising, says Dr. Madan. BMI levels for “overweight” and “obesity” have been lowered recently. Also, as pointed out on April 10, 2013 by the American Council on Science and Health (“Redefining Obesity? The Experts Weigh in On BMI's Validity”), BMI is merely a numerical summary of body weight. One of the weaknesses of BMI is that it does not distinguish between lean muscle mass and fat. One contributor commented, “two individuals, a trained athlete and a couch potato, each with a BMI of 25 would be very different creatures!” Another contributor mentioned that BMI was originally meant just to measure demographic differences, instead of labeling “Michael Jordan or Barry Sanders [as] obese because of their high BMI's when they were playing professional sports”.

The real problem of true obesity, says Dr Madan, is an excess of fat that can lead to diabetes, heart issues, sleep apnea, and a host of other issues. This is a delicate topic to broach with patients, because of the emotional impact of labeling and the sensitivity of needing to talk about healthy options. It is true that lap band surgery is one of the ways of dealing with an unhealthy amount of fat, but it is also true that some people have a higher fat content than others without incurring any life-threatening health issues, or 'co-morbidities'. However, once an extra 50 pounds or so of non-muscle mass is added to the human frame, nearly any body begins experiencing issues. This is one of the reasons why physicians recommend that patients considering lap band, or other bariatric options, should have at least a BMI of 35 to 40, have tried various weight loss methods without satisfying results, and also have at least one co-morbidity. In that way, it would be clear that installing a lap band would be really helpful, instead of just resting on a numerical BMI to determine the necessity of surgery.

Dr. Madan has written over 170 articles in his professional life, and has conducted more than 2,000 weight loss surgeries. In Memphis, the first laparoscopic gastric bypass was conducted by Dr. Madan, who was also the first in recommending a non-surgical treatment for post-surgery weight gain. The University of Miami requested him to fill the position of Chief of Laparoendoscopic and Bariatric Surgery Division, which he did for a few years. In 2007, he received the SAGES Young Investigator Award, and was honored by the American Medical Association Physican's Recognition Award. Dr. Madan's patient reviews had been positive for many years, and in 2011 and 2012 he received the Patients' Choice Award.

For more information on the LAP-BAND procedure or the lap band cost, call 1-800-472-4900, or review more on Dr. Madan on http://www.obesityhelp.com/profiles/bariatric-surgeon/dr-atul-madan/.

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