Weight Loss Drugs - Thoughts?

[JB]

Is this based on BMI? If so, BMI is misleading. It was invented almost 200 years ago, and it's an inaccurate measure of body fat as it doesn't take into account muscle and bone density, among other things. So, for example, an athletic person can score as obese. Some insurance companies charge higher premiums for those with a high BMI, so cynically speaking, it may be in their best interest to keep BMI as a measurement. One Harvard professor referred to BMI as “flawed, crude, archaic and overrated proxy for health.”

BMI gets updated and has.

 

[MtlJeff]

I agree that there are a lot of overweight people, but not sure about 34% being obese. I'm 6'5" and 225 pounds and my BMI is close to obese. I can still see my toes standing up, lol.

I've met you LOL....i know what you look like!

The point i was making was that while there are 100% some people that qualify as obese but are healthy, the vast majority are bringing major risk on.

A lot of columns we read now like to omit the 2nd part and focus on the first part, and portray it as though that is the larger segment.

 

[Sean]

I've met you LOL....i know what you look like!

The point i was making was that while there are 100% some people that qualify as obese but are healthy, the vast majority are bringing major risk on.

A lot of columns we read now like to omit the 2nd part and focus on the first part, and portray it as though that is the larger segment.

I agree that society as a whole is more over weight than probably ever. I simply don't have much faith in BMI.

 

[Sean]

BMI gets updated and has.

According to an article I read, last year the AMA acknowledge the limitations of BMI. Noting, in part, that BMI doesn’t differentiate between lean and fat body mass, and it doesn’t account for differences between racial and ethnic groups and sexes. The AMA suggested that other measurements of health risk be used...like waist circumference, measurements of visceral fat, body composition, along with genetic and metabolic factors.

It's also has a financial component given that insurance companies have been known to use BMI to establish rates. But, as one doctor pointed out: “There are other ways of assessing body fat,” said Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine, but “they’re not as easy and as inexpensive as BMI.” So, I don't think BMI will be displaced as a body fat assessment tool.

 

[tahoebum]

BMI can be misleading, but, for most people, it's not an entirely worthless metric. A relatively small percentage of the population has a BMI that's misleadingly high due to being muscular or having "big bones."

In fact (and please don't make me look this up): One health and fitness coach I follow recently posted the results of a meta study that showed a clear relationship between BMI and VO² Max. Essentially: The higher your BMI, the lower your VO² Max, regardless of body composition. VO² Max has been established to have a relationship to longevity.

If you don't like BMI, though, there's another quick-and-dirty fitness metric: Waist to height ratio.


"Body positivity" is primarily an outgrowth of the calls against "fat shaming." That's all it is.

Yes, lots of studies show a clear relationship between BMI and VO2 max. No doubt BMI is misleading but Americans are also a lot fatter than they were 40 years ago. I see it when I go out in public and especially when I go on campus to visit our daughter. There are a lot of college students, male and female, that are overweight compared to when I graduated in 1988. It’s no wonder diabetes and heart disease are up.

For those who don’t like BMI, waist to height ratio(you should be at least twice as tall as your waist measurement) is often a much better metric than BMI especially for muscular male athletes.

 

[BigMac]

There's a big difference between being "fit" and having visible shredded abs at 40+ years old. At least in my opinion. I don't consider being fit to require sociopathy. I know many fit people that play in adult hockey leagues or flag football leagues a couple of times a week and eat healthy. I can't think of any of these guys having like bodybuilder abs though

One of my good friends does and he is 40 exactly. He works out for 90+ minutes every day. Crossfit style stuff. He build a gym in his shed...stuff like this. Whether that is "sociopathic" is just a matter of wether you consider my comment fun hyperbole (which i did)

When i was 40 i could run a 5-minute mile, deadlift 375lbs and squat 400+ at a weight of 175lbs. I was in the top 1-percentile for chin-ups and pushups in age categories younger than me. I had abs.....and to get to that point was working out more than anyone really needs to. (on my average lunch i would run 5 miles and then get in deadlift sets in under 60 minutes). This is what i consider sociopathic, in a fun, hyperbolic way.

I still run over 50 miles a week and do probably 50+ pushups a day....and i don't have abs anymore at 42.

But if you've seen my nacho thread, you also know i don't eat like a saint.

So yeah, i think to be shredded at 42 you have to do more than what a normal person should have to do. And i'm not "shaming" people who do it.....I did it.

Being shredded with clearly defined abs is more about extremely low levels of bodyfat than anything else - and it does take extreme dedication and discipline to get there. To have truly ripped abs, the vast majority of people (men, anyways) are going to have to be around 10% bodyfat (or lower) - bodybuilders in contest-ready condition are around 5% (men) / 10% (women), and that's not a BF% that one can maintain over the long term because it's actually very unhealthy.

I'd distinguish between wanting to look "healthy/in shape" and wanting to be "ripped". They're different things, with different approaches and levels of dedication required. Somebody who wants to look ripped and have clearly defined six-pack abs is going to have to be a lot more on top of their diet and training than somebody who just wants to look lean and fit, and for most people it does approach sociopathic levels unless their genetics are freaky good.

Here's a couple graphics that give at least a rough idea of what bodyfat percentages look like for men and women:

 

[BigMac]

According to an article I read, last year the AMA acknowledge the limitations of BMI. Noting, in part, that BMI doesn’t differentiate between lean and fat body mass, and it doesn’t account for differences between racial and ethnic groups and sexes. The AMA suggested that other measurements of health risk be used...like waist circumference, measurements of visceral fat, body composition, along with genetic and metabolic factors.

It's also has a financial component given that insurance companies have been known to use BMI to establish rates. But, as one doctor pointed out: “There are other ways of assessing body fat,” said Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine, but “they’re not as easy and as inexpensive as BMI.” So, I don't think BMI will be displaced as a body fat assessment tool.

BMI is clearly a flawed metric, but I don't consider it entirely invalid. If you combine BMI with looking at yourself in the mirror (and are honest about it), you know how much consideration you should give it.

Take two guys who are 5'10 and 175 pounds - one who is at 26% bodyfat and one who is at 14% bodyfat. They're both classified as "overweight", with a BMI of 25.1, but they're going to look vastly different from each other.

 

[AuzzieMatt]

Being shredded with clearly defined abs is more about extremely low levels of bodyfat than anything else - and it does take extreme dedication and discipline to get there. To have truly ripped abs, the vast majority of people (men, anyways) are going to have to be around 10% bodyfat (or lower) - bodybuilders in contest-ready condition are around 5% (men) / 10% (women), and that's not a BF% that one can maintain over the long term because it's actually very unhealthy.

I'd distinguish between wanting to look "healthy/in shape" and wanting to be "ripped". They're different things, with different approaches and levels of dedication required. Somebody who wants to look ripped and have clearly defined six-pack abs is going to have to be a lot more on top of their diet and training than somebody who just wants to look lean and fit, and for most people it does approach sociopathic levels unless their genetics are freaky good.

Here's a couple graphics that give at least a rough idea of what bodyfat percentages look like for men and women:

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At this stage I'd take 20% over my 40%.

 

[BigMac]

At this stage I'd take 20% over my 40%.

I got down to around 13-14% in early 2020, right before COVID shut down all the gyms, and was pretty happy with how I looked (given the genetics I have to deal with). I was around 203-205 lbs at 6'6". I don't carry a lot of muscle mass so I was on the skinny side, but I had at least the beginning of ab definition and no love handles. The effort it took to get there wasn't what I'd call Herculean, but it was definitely a significant departure from my baseline levels of activity and diet. I wasn't subsisting on dry chicken breasts and steamed broccoli, but I was eating a lot less of many things and a lot more of other things. I still ate pizza and burgers and chocolate and ice cream and stuff, but a lot less often and in smaller quantities.

I'm currently in the 20-25% range and 35 lbs. above where I was then, and I have no excuses and nothing to blame but my own laziness and lack of discipline. I refuse to place the blame anywhere else, because I've done it before, I know what it takes, and I know I can do it. I don't need weight loss drugs (and wouldn't use them), I just need to get off my fat ass and do what I need to do. It's simple, but it's not easy.

 

[Duffer Seamus]

I can still see my toes standing up, lol.

Perhaps you're conflating "obese" with "morbidly obese?"

... I'm 6'5" and 225 pounds, my BMI is close to the obese range and I'm not sure I'm even over weight, let alone obese.

At 6'5" and 225 lbs. you're squarely in the middle of the "overweight" category as per the NIH BMI Calculator, not obese.

I'm 6'4". I have weighed up to 230 lbs. I don't know as I'd have called myself "fat," back then, but, in a side-on photo of me looking through by shiny new spotting scope I'd received for Christmas you could clearly see a double chin when I was in that position. I was wearing 36 in. waist pants at the time and they were quite snug.

I still have a bit of a pot belly going (can now only be seen when I'm shirtless) and I'm at ±180 lbs. I'm down to 34 in. pants having a bit of breathing room. The BMI calculator pegs me about dead middle of the "normal" range.

Most people are carrying a lot more fat than they think they are. What fools them is the general overweight/obese condition of the vast majority of Americans.

Compare what you see on the beach these days to this photo from the 1970's:

By today's standards (or the lack thereof): Many of those people look downright anorexic. They're not. They're just not overweight.

What does your Waist to height ratio come out to?

 

[aaa1988]

People are obese these days because for the most part we are lazy. As a culture we eat fast food, eat pre packaged foods, drink tons of soda etc. I can probably count the number of times I had fast food before the age of 16 on one hand. My grandparents and parents grew 85% of our vegetables and we raised chickens, pigs and beef cattle. We rarely bought from grocery store and they were fit and looked like people who are gym rats. So much processed food and proteins loaded with hormones in the world right now.

 

[Duffer Seamus]

Here's a couple graphics that give at least a rough idea of what bodyfat percentages look like for men and women:

The one for men looks to be pretty much in-line with something I read on X, recently:

"For now, I'll treat you to something I created in the midst of writing this book. The "android" distribution of body fat is characterized by the greatest concentration of fat storage occurring in the abdominal area. In other words, men tend to wear most of their body fat on their beltline. So, I present to you the proprietary Measurement-Free Body Fat Calculator for Men (Box 8L). Please note that it's not 100% serious, but it's surprisingly accurate for the limited range that it covers. I almost didn't include it, but I figure that my audience can handle this level of slapstick."

Box 8L: Measurement-Free Body Fat Calculator for Men *

. 4-5% - Sharp, crisp six-pack, contest-ready, dangerously near death.
. 6-8% - Solid six-pack, all abdominal rows clearly visible, life clearly miserable, camera-ready.
. 9-12% - Softer six-pack, bottom row not as sharp, but still visible, no one cares but you.
. 13-16% - Bottom row not visible, "blurry four-pack" of the gods, no one's really impressed, but no one's really offended, either.
. 17-20% - Only top row visible, still has plenty of mojo.
. >20% - No visible abs, still has great personality.

* This is a combination of satire and reality.

Excerpted From:

Flexible Dieting: A Science-Based, Reality-Tested Method for Achieving and and Maintaining Your Optimal Physique, Performance & Health - Alan Aragon, @TheAlanAragon on X

My BIA body fat analyzer currently pegs me at around 15%. That graphic you posted, @BigMac, and Aragon's "Measurement-Free Body Fat Calculator for Men" have me closer to 20% or a bit higher.

I'm aiming to hit a legit 15%: "Blurry four-pack of the gods"

 

[BigMac]

The one for men looks to be pretty much in-line with something I read on X, recently:


My BIA body fat analyzer currently pegs me at around 15%. That graphic you posted, @BigMac, and Aragon's "Measurement-Free Body Fat Calculator for Men" have me closer to 20% or a bit higher.

I'm aiming to hit a legit 15%: "Blurry four-pack of the gods"

BIA is such an unreliable method of measuring body fat. It's an educated guess and can be useful for tracking trends if done under consistent conditions (same time of day, same fed/hydrated status, etc.) - I trust the trends, but I don't trust the numbers. My BIA scale currently shows me at around 20%, and I know from looking in the mirror that I'm closer to 25% right now.

When I was on track and doing what I should be doing, I was taking measurements monthly with bodyfat calipers, using the Jackson/Pollock 3-site method (chest, abdominal, thighs), and those results correlated more closely with what I was seeing in the mirror.

"Blurry four-pack of the Gods" is a great description for the 15% range, lol!

 

[Sean]

What does your Waist to height ratio come out to?

0.49. When I think of obese I think of extremely fat. Morbidly obese I think of Jaba the Hut, lol.

 

[Duffer Seamus]

BIA is such an unreliable method of measuring body fat. It's an educated guess ...

Yes, I know. When you have something claiming your body fat is jumping back-and-forth by 1% from day-to-day you know what it's telling you must be a SWAG.

... and can be useful for tracking trends if done under consistent conditions (same time of day, same fed/hydrated status, etc.) - I trust the trends, ...

That's all I use it for. And, even then, I don't trust the reading on any particular day. I record what it tells me each morning and average them for a weekly number.

 

[BigMac]

Yes, I know. When you have something claiming your body fat is jumping back-and-forth by 1% from day-to-day you know what it's telling you must be a SWAG.

Exactly, lol. This is my BF% plot over the last four weeks, it thinks I vary quite a bit from day to day:

 

[j0nesy]

If you really want to know your body composition with accuracy, find a Dexascan. In Jersey a Dexascan is reasonably priced at $150 and many of the places that offer these services also have other scanning services that would be of benefit.