I'm about 6'1" tall and normally weigh about 230 to 235. I have a large frame, meaning my bones are very large. I can't wear a belt-strap watch because the bands are never long enough for my wrists. I know I could stand to lose a few pounds, but I look like a standard mesomorph in street clothes: no paunch, no love-handles, etc. My shoulders are broad, torso and arms well muscled, and when I was younger I could bulk up easily just by casual weight-lifting. My hands and feet are large and broad: I wear a size 12EEEE shoe. A 7-3/4 hat is snug on my head. People always wonder if I played linebacker in school.

Now, the weight charts I've seen say I'm overweight for my height if I'm over 212 lbs. The problem is, at 220 I look lean. A few years ago I dieted down under 200 to meet this idiotic "standard": the result was, my friends and co-workers kept asking me if I had cancer or AIDS. They were worried something was wrong because I looked positively gaunt. I felt cold everywhere, even in summer.

I'd be willing to keep my weight around 220 if it made a difference, but where does anybody get off telling me I need to be 212 to meet some artificial, one-size-fits-all standard? If you have a pencil-neck frame you can do that easily, but if you're built more robustly it's an idiotic request. Why not make everybody wear the same size clothes, if that's the plan? It amounts to the same thing.

The point is, as soon as you have this idea of penalizing people for being "overweight" you run into a bunch of bureaucratic standards that just don't fit people like me.

Here is why: medically, a simple and effective tool is needed to screen for obesity. The simplest way to do this is BMI. No medical professional would think a linebacker is with obese.

So you go to your doctor and get weighed. They put your weight and height into a formula and get you BMI. It says 28, which is elevated, but they look at your bulging muscles and say your fine. If they are concerned, they do actually body fat measurements. The simplest is to take a caliper to a few areas and measure your fat. More complex but acurate measure invovle submesring you in water.

So that is the answer to your question. BMI is used because it is simple. If BMI is elevated, there are further tests to determine actual body fat percentage.

Yes, but robusto has a valid point.

BMI may have limited utility for studying groups. If indviduals however are going to be penalized a more sensitve measure then BMI would be required for the reasons mentioned in the top post (among others).

Private insurance companies provide discounts in all lines of insurance when people take steps to reduce risk; e.g. don't have tickets, put in smoke alarms or a fire retardant roof, etc....

Health insuers should be allowed to do the same. The only question here is what are legit factors to use. Total weight is NOT a legit factor for reasons you gave but having standards is a valid overall concept.

FeTuS:

Here is why: medically, a simple and effective tool is needed to screen for obesity. The simplest way to do this is BMI. No medical professional would think a linebacker is with obese.

You've plainly never seen Levon Kirkland suit up.

jazzguitarman:

Private insurance companies provide discounts in all lines of insurance when people take steps to reduce risk; e.g. don't have tickets, put in smoke alarms or a fire retardant roof, etc....

Health insuers should be allowed to do the same.

That's a great idea! How about this one: men who don't have sex with other men pay half the premiums of men who do. We can also start charging women who are sexually active and aren't on hormonal birth control more than women who either aren't sexually active or are on birth control.

Then we can start on contact and extreme sports and people who don't wear enough sunscreen... Hmmm, then there's also people who choose to live in dangerous (poor) neighborhoods. Why should the rest of us foot the bill for these peoples' irresponsible lifestyle choices?

And heck, while we're at it, why should the rest of us be asked to foot the bill for people who drop out of high school or commit felonies and as a result can't get a job that offers health insurance? Why shouldn't those people pay for their bad decision-making?

That'a funny. You're 6'1" and wear a size 7 3/4 hat. I'm 5'5" and wear a 7 3/4 or a 7 7/8 hat.

I've always had the watch band issue also. Even in highschool and college.

Heck, my ankles are the size of a super models thighs.....

But one good thing comes of large dense bones......never broken a bone. Heck, never sprained an ankle either....and I played sports. Now I did sprain my neck stupidly taking a head dive at a floor in gym class eons ago.....

TheyCallMeBruce:

jazzguitarman:

Private insurance companies provide discounts in all lines of insurance when people take steps to reduce risk; e.g. don't have tickets, put in smoke alarms or a fire retardant roof, etc....

Health insuers should be allowed to do the same.

That's a great idea! How about this one: men who don't have sex with other men pay half the premiums of men who do. We can also start charging women who are sexually active and aren't on hormonal birth control more than women who either aren't sexually active or are on birth control.

Then we can start on contact and extreme sports and people who don't wear enough sunscreen... Hmmm, then there's also people who choose to live in dangerous (poor) neighborhoods. Why should the rest of us foot the bill for these peoples' irresponsible lifestyle choices?

And heck, while we're at it, why should the rest of us be asked to foot the bill for people who drop out of high school or commit felonies and as a result can't get a job that offers health insurance? Why shouldn't those people pay for their bad decision-making?

This is one of the arguments I just dont get. The whole reason obesity is being looked at is it has replaced smoking as the largest preventable health risk in the US. Its costs are staggering in terms of dollars and lives. Extreme sports dont even register on the scale. Gay sex doesnt even register. So I will pass on the slipery slope argument. We arent talking about increasing insurance premiums for skateboarders here. We are talking about talking preventable health risk #1.

FeTuS:

This is one of the arguments I just dont get. The whole reason obesity is being looked at is it has replaced smoking as the largest preventable health risk in the US. Its costs are staggering in terms of dollars and lives. Extreme sports dont even register on the scale. Gay sex doesnt even register. So I will pass on the slipery slope argument. We arent talking about increasing insurance premiums for skateboarders here. We are talking about talking preventable health risk #1.

But in the end, if we truly wanted to charge people health insurance premiums based on their actual risk, wouldn't it make sense to charge those of us who lost parents or siblings to cancer more? Or to have genetic screenings to determine if we have a propensity towards certain very expensive diseases?

FeTuS:

This is one of the arguments I just dont get. The whole reason obesity is being looked at is it has replaced smoking as the largest preventable health risk in the US. Its costs are staggering in terms of dollars and lives. Extreme sports dont even register on the scale. Gay sex doesnt even register. So I will pass on the slipery slope argument. We arent talking about increasing insurance premiums for skateboarders here. We are talking about talking preventable health risk #1.

I think that is a decent argument. Why should you have to pay for somebody else's vices? Why shouldn't people be responsible for their own choices?

But then, why in the world limit it to obesity? I don't think anybody is arguing that we shouldn't charge for obesity because it might become a slippery slope and skateboarders might get charged. The argument instead is, ok, let's talk about personal responsibility but let's talk about it across the board. It is only fair that ALL choices be put on the table and people should take responsibility for every one they make that increases their health risk.

The fact that only a small portion of people risk their life in extreme sports has nothing to do with the fact that they are increasing their risk levels. If it is about personal responsibility then the individual is the only level that matters.

I'm willing to go either way. People can be responsible for the burden that they put on health care OR groups can be designed so everybody holds a portion of the total group burden. But I've yet to see any argument that justifies making some people responsible for their choices and yet let's other people off the hook for theirs - unless of course its the truth of "I'm not willing to set the same standards for myself as I hold others too".

KB01:

But in the end, if we truly wanted to charge people health insurance premiums based on their actual risk, wouldn't it make sense to charge those of us who lost parents or siblings to cancer more? Or to have genetic screenings to determine if we have a propensity towards certain very expensive diseases?

I'd love for doctors to start respecting young people's choice for permanent sterilization (vasectomy, tubal ligation) and then we can have one set of health plans for breeders and one for non-breeders. We could take care of the gays in that way too. Seriously, I'd bet pregnancy related costs are at least equal to obesity related costs in health care. Why should I pay for people who choose to get pregnant?

How interesting that, out of my entire two posts, THAT is what you chose to focus on.

I'm not going to derail the thread that much though by following up on it.