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Should Employee Health Programs Be Using BMI as Health Indicator?

Should Employee Health Programs Be Using BMI as Health Indicator?

Jan. 9, 2023
Due to a number of factors not being considered in this measurement, it's just part of the picture.

To edit the old expression that nothing in life is certain but death and taxes, I would add weight loss in January is a given.

Being overweight, especially morbidly obese is the cause of many serious health diseases. It can lead to heart disease, Type 2 diabetes, cancer, high cholesterol, high blood pressure, and joint problems.

And those illnesses translate into high costs. The Centers for Disease Control and Prevention (CDC) reports nationally, annual obesity-related medical care costs in the U.S. are estimated to be $173 billion.

Looking specifically at the cost of productivity, the CDC says the cost of obesity-related absenteeism ranges from $3.4 billion ($79 per individual with obesity) to $6.4 billion ($132 per individual with obesity).

Those numbers are based on the 42% of the population that is considered obese in 2022, which is up from 30% in 1999.

Given that obesity is a leading cause of preventable disease and even premature death, many employers have implemented weight loss programs, as part of their overall wellness programs.  And one measure that many programs rely on is the body mass index BMI. It’s measured by weight divided by height.

But is this a good measurement? To put this in some perspective, in an article by Cleveland Clinic, they point out that Tom Brady, the quarterback, has a BMI that puts him in the overweight range. 

But this measurement isn’t all bad. According to Leslie Heinberg, Ph.D., director of Enterprise Weight Management for the Cleveland Clinic says using this number is complicated. For example, those whose BMIs are in the overweight or obesity ranges are at higher risk for developing diabetes than people in the normal range. “That risk may be twice as high,” says Dr. Heinberg, in the article. “But when you look at people whose BMIs are more than 40, the risk may increase to 20 times higher.”

While BMIs that are either too high or too low isn’t a guarantee that someone will develop a chronic disease, it’s one piece of information in an overall health evaluation. And there are a few factors that make this number actually inaccurate. One category is race and ethnicity since these are lumped together and lead to unclear results when research is showing that “there are biological and genetic differences in the relationship between weight, muscle mass and disease risk among different groups of people. BMI does not account for that,” the article concludes.

Then there is the issue of muscle mass in people who are athletic tend to have a higher percentage of lean muscle mass and a lower percentage of fat mass than the average population. They could come out in the overweight category when in fact there are in great health.

And let’s not even get into the issue of body shape – pear or apple. “BMI does not take waist circumference into account,” explains Dr. Heinberg. “Two people can weigh the same and, therefore, have the same BMI. But their risk for disease might not be the same.

And last, but not least, given the general age of the workforce, older adults tend to have more body fat and less muscle mass, but that may in fact protect them from developing certain diseases.

So, what’s the conclusion? Don’t be beholden to your BMI number but do stay a weight that is healthy for your particular circumstances. 

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