Obesity and BMI: Blatant Misuse of Information?

By Topher Adams

In an effort to preemptively curtail an obesity epidemic, the South Korean government is taking steps to educate its citizens about health and diet.

The most apparent of these measures is the literature about obesity and diet that are sweeping the nation. These government-funded pamphlets can be found in almost every major institution, from public and private schools, to hospitals and pharmacies. Additionally, government programs have funded the purchase of anthropometrical analysis machines for public schools, most notably in South Gyeongsang Province.

The government must be commended for having the foresight to try to fight off the obesity epidemic before it hits. However, in educating the public, they might have done a great disservice without knowing it. One example that immediately comes to mind is the outdated and inaccurate Body Mass Index (BMI) in rampant use across the country.

The scientific community has admitted to the shortcomings of BMI for decades. BMI uses only height and weight measurements to estimate body fat, and overlooks more important factors such as fat-free mass (FFM). The calculation assumes body composition and mass distribution are the same for all patients, where in reality this is clearly not the case.

The BMI method cannot distinguish between body fat and fat-free mass, which is a serious flaw. This process may overestimate the body fat in an athlete who has more FFM, and underestimate the body fat in the elderly who have subsequently lost FFM.

Whereas BMI appears to be more accurate in both the high and low ends of the scale, it is widely inaccurate in the average range, where precision is needed the most. Individuals at the extreme ends know they are either under or overweight and probably are not enlightened by the BMI results.

It is the individuals who are unaware of their potentially dangerous BMI who truly need to know. In contrast, it is important for healthy individuals to know they are healthy, regardless of what others and societal standards may deem appropriate.

In a society that no doubt puts tremendous pressure on young people to ``fit the mold," using BMI as a daily indicator of health creates a dangerous precedent among its citizens. For young women in particular, being self-conscious about your weight can be a great burden. In conjunction with unfair standards set forth by the government, citizens might be getting the wrong message, or worse, no message at all. One may consider making the correlation between societal pressure, body image, and the rising suicide rate in this country.

Regardless of the methods most used by government programs, we still must commend them for the initiative. The process of education and distribution is undoubtedly working, but needs minor adjustments. A much more indicative and accurate method is Waist-Hip Ratio (WHR). This method requires only a measuring tape and a calculator (or sixth grade math).

It can more accurately indicate fat in the abdominal area, which is a risk factor for diabetes, cancer and cardiovascular disease. Low-cost and accurate for all demographics, this is the best alternative to expensive or invasive methods such as skin-folds.

While the government is on the right track with its tactics, I suggest incorporating WHR as the foremost method for predicting health risks associated with obesity. With accurate information for every individual, regardless of bone structure and fat-free mass, the government can truly stamp out the obesity epidemic, or as close as possible without regulating the hours spent playing computer games.

The writer is kinesiologist and physical education teacher born and raised in western Canada. He is currently teaching in public elementary schools in Geoje, South Gyeongsang Province. He can be reached at hills.c@shaw.ca.