[graeme]

Edit: I read OP’s argument the wrong way. So my comment below is based on a misapprehension.

———-

This is foolish. BMI is used to estimate population averages. But waist measure is vastly better. Someone with a waist of 31 at 5’6” actually has close to ideal portions, if you’re talking about a man. (For women you need the hip measure too).

That’s a waist to height ratio of about .47. A person with that waist probably has a high muscle mass + low body fat.

Now, if the same person was 155, 5’6” and had a 34 inch waist, they are almost certainly overweight.

https://trustyspotter.com/blog/perfect-male-body-measurement... https://www.omnicalculator.com/health/Waist_Height

Both people will show up as “overweight” in population averages, which isn’t an issue as edge cases balance out over the whole population. But you’re talking as though such a person with a 31 inch waist should actually lose weight.

[oreaway]

>But you’re talking as though such a person with a 31 inch waist should actually lose weight.

No, I'm not. I never said such a thing and I have no idea why you're building such a strawman.

Waist measure has nothing to do with this story. This story is about COVID-19 comorbidities, of which being overweight (which is medically measured using BMI, not waist measures) is one. BMI is all that matters in this context.

If you are 5'6" and 155 lbs, you are classified as overweight and thus are considered a high-risk person for COVID-19. That has nothing to do with "you should/should not lose weight".

And the broader point is this: if you see any stats saying "most COVID-19 deaths were overweight people", you shouldn't feel any sense of "safety" because you think "well I'm not overweight, I wear size small!", because there's a good chance that a lot of those COVID deaths wore smalls, too.

[porknubbins]

Has there been data showing that people with 25-30 BMI are at an elevated risk? I have’t seen that anywhere, everything I’ve seen has been about obesity. I would be very surprised considering that level of BMI has even been shown to be beneficial in elderly surviving some diseases.

[graeme]

> If you are 5'6" and 155 lbs, you are classified as overweight and thus are a high-risk person for COVID-19. That has nothing to do with "you should/should not lose weight".

This is absolutely false. It is the adiposity that raises risk. High muscle mass is not a risk factor. You’re got an erratic view of what we mean by overweight: we mean excessively adipose.

I took it as implied that you thought overweight people should lose weight for health reasons, but that isn’t the central point.

BMI approximates population averages and is useful as such, but for an individual the correct question to ask is whether they are excessively adipose. Someone at 5’6” with a 31 inch waist and a weight of 155 is almost certainly not excessively adipose.

[oreaway]

You're completely missing the point. These studies don't give a damn about your adipose, or how much weight you need to lose. These studies are about whether or not you are classified as overwight, which is based solely on BMI, and nothing else.

Someone 5'6" and 155 lbs is overweight and thus is considered a high risk COVID individual, regardless of their waist size. If that person were to die of COVID, they would be reported as "had high-risk underlying health conditions".

That's what we're talking about in this context. Everything else you are talking about is completely irrelevant.

Responding to your above edit (which you now have removed):

>I agree many people underestimate their own adiposity, but the given example of 31 inch waist at 5’6” and 155 pounds indicates a trim, fit person.

This statement just highlights the entire point. You think it means "trim, fit person", as do most others. But the medical definitions do not agree with you. According to the medical definition, that person is overweight. That's the bottom line.

[graeme]

Ah I misread OP as saying people downplay obesity and don’t consider themselves fat. I took you to be giving an example of someone who thought they were not fat but were in fact fat.

Rereading OP’s comment I see they’re instead talking about people downplaying covid because they think it only affects people who are morbidly obese. My mistake.

Though, I suspect probably at least 80% of the people in the overweight/obese category legitimately have too much fat. Especially in america. Compared to the rest of the oecd, america has a much larger portion of “morbidly obese” within the obese category.

BMI does also underestimate obesity in some. On average it’s a reasonable definition of overweight/obese. The example you gave is an edge case, but the studies concern themselves with averages.

[oreaway]

I understand what you're saying and I see the confusion. To be more clear, I agree with you and BMI is a terrible measure of "overweight"/"obesity".

As someone who is 5'7" and 160 pounds, I'm considered "overweight", but if you saw me in person I'm almost certain you wouldn't think of me that way because I look quite fit. In reality, I have a decent amount of muscle mass from being physically active, but the BMI measure doesn't take into consideration muscle vs fat, and thus I am technically "overweight".

My point was not that everyone who is technically "overweight" is "fat" or "unhealthy", but rather that the COVID-19 reporting statistics that use those words are also using that "terrible measure" of BMI, and according to BMI, even typically-seen-as-healthy people fall under that "high risk" category, and people should be aware of that rather than assuming they are safe from COVID just because they are "fit".

[graeme]

I think you may be going a little far with this still though. Overweight is a risk factor, and someone who is overadipose absolutely is at higher risk.

For yourself, you would make the sensible adjustment of “well I’m not overadipose and therefore do not have higher risk from that factor”. That doesn’t mean you’d have no effects, it merely means you lack one risk factor.

But overadiposity absolutely is a risk factor and those in that group should be even more careful: the more overadipose, the more so.

BMI is used that way for studies because it’s a useful measure over groups. The exceptions run both ways and balance out. It just shouldn’t be applied blindly to individuals.