April 3, 2012
Study Finds Current BMI Scale Too Lenient When Diagnosing Obesity
Lee Rannals for RedOrbit.com
Researchers reported in the journal PLoS ONE this week that obesity in America is significantly worse than previously thought.
According to a study by Eric R. Braverman, M.D. and Nirav Shah, M.D., M.P.H., the BMI formula is an outdated mathematical equation that needs to evolve to help correctly evaluate body fat.
The study suggests that adjusting the BMI will have broad population health implications, leading some who were not necessarily considered to be obese, to tip the scale towards the obesity side.
Braverman and Shah compared the results of the Body Mass Index formula of participants in the study, to a Dual-energy X-ray Absorptiometry (DXA) scan. The DXA scan is a direct simultaneous measurement of body fat, muscle mass and bone density.
They found that as many as 39 percent of Americans who are classified as overweight are actually obese by adiposity measures.
The researchers said that misclassification occurred more frequently in women than in men, and was exacerbated by increasing age.
"BMI, at best, even with new cutpoints, is only accurate about 75% of the time," Braverman told RedOrbit in an email. "BMI is poor science and measurement, and needs to be adjusted by leptin."
Hyperleptinemia, or over-active leptin, of aging helps to explain why diets fail Americans who are eating fewer calories as they age, but still gain weight.
The researchers said leptin is the first blood test useful in diagnosing and treating obesity, and changing the levels can lead to permanent weight loss.
They said as leptin levels rise, obesity may become irreversible, calling for the public health need for early leptin measurement.
Patients who have over-active leptin can help correct this by using a variety of hormones, nutrients, medication, and lifestyle changes.
Braverman, who is the Founder and President of PATH Foundation NY and PATH Medical, has developed a grid that shows the leptin adjustment for BMI, which he said should be used along with a blood leptin for evaluating whether an individual is obese.
When using this grid, an individual must determine their BMI by locating height and weight. Once they have found their BMI class by color, they can use the Leptin Adjustment for BMI table to determine their body adiposity percentage based on their BMI class, leptin level, and age.
He said he hopes his publication with the Commissioner of Health, and interest shown by Governors and Congressman, will help this new obesity scale latch on in the medical community.
"Everyone in America needs to have a DXA body fat scan simultaneously when they do a bone density scan," he told RedOrbit. "The idea of paying research funds based on BMI, when it is inaccurate, is incredible, especially since it was developed as a math equation in 1832."
Braverman has been treating obesity in patients since 1984, and he said that "BMI usually says they are okay when they are flabby."