[edit] Limitations and shortcomings
The medical establishment has generally acknowledged some shortcomings of BMI.[11] Because the BMI is dependent only upon weight and height, it makes simplistic assumptions about distribution of muscle and bone mass, and thus may overestimate adiposity on those with more lean body mass (e.g. athletes) while underestimating adiposity on those with less lean body mass (e.g. the elderly).

One recent study Romero-Corral et al. found that BMI-defined obesity was present in 19.1% of men and 24.7% of women, but that obesity as measured by bodyfat percentage was present in 43.9% of men and 52.3% of women.[12] Moreover, in the intermediate range of BMI (25-29.9), BMI failed to discriminate between bodyfat percentage and lean mass. The study concluded that “the accuracy of BMI in diagnosing obesity is limited, particularly for individuals in the intermediate BMI ranges, in men and in the elderly… These results may help to explain the unexpected better survival in overweight/mild obese patients.”

The exponent of 2 in the denominator of the formula for BMI is arbitrary. It is meant to reduce variability in the BMI associated only with a difference in size, rather than with differences in weight relative to one’s ideal weight. If taller people were simply scaled-up versions of shorter people, the appropriate exponent would be 3, as weight would increase with the cube of height. However, on average, taller people have a slimmer build relative to their height than do shorter people, and the exponent which matches the variation best is between 2 and 3. An analysis based on data gathered in the USA suggested an exponent of 2.6 would yield the best fit for children aged 2 to 19 years old.[13] The exponent 2 is used instead by convention and for simplicity.

Some argue that the error in the BMI is significant and so pervasive that it is not generally useful in evaluation of health.[14] Owing to these limitations, body composition for athletes is often better calculated using measures of body fat, as determined by such techniques as skinfold measurements or underwater weighing and the limitations of manual measurement have also led to new, alternative methods to measure obesity, such as the body volume index. However, recent studies of American football linemen who undergo intensive weight training to increase their muscle mass show that they frequently suffer many of the same problems as people ordinarily considered obese, notably sleep apnea.[15][16]

A further limitation relates to loss of height through aging. In this situation, BMI will increase without any corresponding increase in weight.

To overcome the shortcomings of BMI, and some of the less acknowledged limitations inherent in body fat percentages, the concepts fat-free mass index (FFMI) and fat mass index (FMI) were introduced in the early 1990s.[18]http://en.wikipedia.org/wiki/Body_mass_index

Good luck. I hope things work out.

Tonight and quite often I throw vegetables and shrimp, which has hardly any calories it it, in a skillet and that is dinner. Very low in fat and calories. I don’t eat much red meat. I eat more chicken baked or in the skillet with light spray oil, baked fish and veggies. I don’t eat white pastas, breads or rice as it has bad carbs, which turn into fat. Do I like the occasional desert of course who doesn’t. Unfortunately some foods that are high in sugar can turn to fat.

I used to be able to pack it away, but the older a person gets (I am in my mid 40s) the less they eat, but also the less they are able to lose weight. I try to make good food choices. I always look at labels before buying any food. I don’t eat high fat content foods. My family is not made up of tiny skinny people. My uncle is 6′6″ and very large framed. My father and mother were also tall and large framed. Even when I did lose weight according to the bogus weight charts that are out there I looked skinny and sick and at that time weighed 155lbs. I never did reach the goal weight of 145lbs or whatever they decided was the “perfect” weight that was set for me; it was impossible. Some people just cannot be “skinny” by society’s standards.

With the current administration in Washington they just may be out of business if we go to socialized or universal healthcare, so it would behoove them to stop discriminating and provide coverage for all that need and want it.

discrimination, favoritism, favouritism is the unfair treatment of a person or group on the basis of prejudice (http://www.wordreference.com/definition/discrimination)

1 a: the act of discriminating b: the process by which two stimuli differing in some aspect are responded to differently
2: the quality or power of finely distinguishing
3 a: the act, practice, or an instance of discriminating categorically rather than individually b: prejudiced or prejudicial outlook, action, or treatment
http://www.merriam-webster.com/dictionary/discrimination

I was denied insurance do to a BMI the insurance company made up. They inflate the BMI. Also a one size fits all calculation for BMI is not accurate and a high BMI does not always mean fat and unhealthy. Athletes have higher BMI’s due to muscle mass. FYI – Losing weight for many is not as easy as you think. I don’t eat crap like twinkies. Learn about weight and metabolism before you comment.

More on BMI:

*“BMI can be calculated quickly and without expensive equipment. However, BMI categories do not take into account many factors such as frame size and muscularity.[9] The categories also fail to account for varying proportions of fat, bone, cartilage, water weight, and more.”

*“The medical establishment has generally acknowledged some shortcomings of BMI.[11] Because the BMI is dependent only upon weight and height, it makes simplistic assumptions about distribution of muscle and bone mass, and thus may overestimate adiposity on those with more lean body mass (e.g. athletes) while underestimating adiposity on those with less lean body mass (e.g. the elderly).”
http://en.wikipedia.org/wiki/Body_mass_index

I was diagnosed with Hashimotos hypothyroidism with a TSH level of nearly 20. I gained weight on 800 calories a day (documented and medically supervised).
By the time my disease was diagnosed, nearly 80 pounds had been packed onto me and it had NOTHING to do with diet at all. Nothing.

Now I get the burden of trying to lose it. It does not magically disappear once medication regulates the thyroid.

So I diet and exercise and lose 30-40 pounds, and the thyroid function decreases more, and those pounds come back very, very quickly, before the medication can pull it back into normal range. And there I am again….all that lost weight for nothing.

Lather, rinse, repeat. It never ends.

And for all this, I get to be called fat, lazy, “Twinkie eater”, etc.

If this wasn’t so awful, I’d wish it upon some of you so you can have your eyes opened.

You may want to punish people that you think aren’t as self-controlled and disciplined as you, but your bias will come back to bite you in the end.

In the meantime, I think we should lobby to deny coverage to athletes, who cost us an extraordinary amount of money for medical costs related to avoidable injuries.

BUT

Also charge more insurance for people on prescription drugs.
AND for people who use illegal drugs (drug test everyone – all the time).
AND people who drink.
AND people who smoke or chew tobacco.
AND people with congenital health issues.
AND people with PAD
AND people with AIDS or cancer or other deadly diseases

And yes. We all need to be healthy. But the way we are going at it with all these labels and stuff, its going to take a long time before we get thin and fit.

It’s called eat in moderation and stop crash dieting.

So, according to “helpful” people, my husband and I should be paying higher insurance premiumns because he was under weight and because he is now over weight–all because his his health issues will cost more to cover his treatments. It really doesn’t matter that he was not “lazy”, he just is a bigger risk.

So tell me how exactly how obesity (either caused by heath issues or “laziness”) is really any different than heart disease or diabetes? Exactly who is qualified to make the distinction on laziness and health issues, God or man? Do you want the job? I don’t!

There are a number of behaviors that can result in increase cost. Where would you draw the line?

By the way, I am slim, eat healthy and exercise. But because I had premature menopause staying slim is an uphill battle. How many people here know that for woman’s metabolism changes greatly after the menopause, to the point that some women can eat 1200 calories a day and still gain weight; slowly but surely. Then there is weight gain that is side effect of some medications, like prednisone (not sure I spelled it right).

Here is by the way an interesting post from a doctor’s blog related to the subject from some time ago:
http://dinosaurmusings.blogspot.com/2006/12/patient-responsibility.html

This post was in response to a West Virginia plan to vary coverage for medicaid patients based on certain behaviors, being obese was one of them. It is pretty enlightening.

I find your discussion of discrimination in terms of employee health care coverage costs based on one’s BMI to sponsor an insightful viewpoint. The figures linking one’s medical costs to weight are truly dramatic and eye-opening and knowledge of such statistical evidence should be broadcast across the nation, as a means of raising a red flag to the millions of ‘affected’ Americans. Concerning your posed question of discrimination and reasoning, stating that “overweight individuals cost the company more in health insurance costs� than do normal weight individuals, I do not wholly feel that charging obese individuals more for employer based health insurance is hypothetically unfair. However, as to whether or not this is just, I am less willing to consent. According to Damon Darlin, author of Extra Weight, Higher Costs, as referenced in your post, heavier individuals accumulate higher medical bills and pull in lower wages over their shortened lifetimes. Due to their chronic disease, they are at an exceptionally increased risk of suffering from expensive and potentially debilitating ailments such as arthritis, diabetes, diabetes, and heart disease. In terms of fiscal content, these disorders cost around $80 billion annually, for the over 97 million obese and morbidly obese Americans. With 85 percent of this monetary burden being covered by insurers, tax payers, and the government, the inclination toward increasing coverage costs for individuals with a BMI of 25.0 or above is understandable. Individuals battling obesity and the related conditions do not need the added stress of funding these newly acquired ailments due to the implementation of health care related economic discrimination. Although many of their health problems are catalyzed by being over weight, inculcating these individuals with higher premiums will neither dramatically lower governmental healthcare spending nor curtail the obesity epidemic. It will however, likely lead to an increase in the number of uninsured Americans. Rather, the cause of obesity should be the topic at hand, not the resulting symptoms and ailments. The external reward of fiscal gain due to a ‘normal’ BMI will never consistently overcome the temptation toward unhealthy eating habits for bingers, but the intrinsic reward of benefiting one’s own health and well-being may. Thus, while on paper it may seem logical to ‘overcharge’ the overeaters, it will not solve anyone’s problems.