Are people with high BMIs unhealthy?

Many American companies have been using BMI as a shortcut to assess their employee’s health status? This approach makes sense, right? Public health agencies often detail the severe health consequences of overweight and obesity. The US Public Health Service Task Force guidelines state that patients with obesity should receive intensive weight loss counseling. Even the American Medical Association calls obesity a “disease.”

Despite this, a sizable number of those with high BMIs have completely normal cardiometabolic functioning. In other words: they’re overweight/obese and otherwise and healthy.

These are the findings of a recent report from colleagues at UCLA. They found that nearly 50% of people with overweight and almost 30% of those with obesity are, in fact, metabolically healthy.

This finding is being interpreted as “the final nail in the coffin” for BMI. There’s no question in my mind that BMIs demise would be welcome to many (in my experience, people love to assail BMI as non-specific, not relevant to specific groups, and a poor measure of fatness — some days, I agree).

But, I suspect the reports of BMIs demise are greatly exaggerated.

The idea of being metabolically healthy while obese is not a new one. Although the size of the metabolically healthy population is a mater of some debate, their existence is well accepted.

But here’s the thing that the recent study didn’t consider: time.

There’s some evidence that people’s likelihood of being obese and healthy drops as they age. Put another way, wait enough time and obesity will start having negative health effects. There’s also emerging data suggesting that the time spent in obesity — literally the number of years that someone spends in an obese state — is independently associated with negative outcomes. This is a particularly potent health risk since very (very) few people with obesity ultimately lose weight (and keep the weight off).

So, it’s true: companies that want to quickly assess employee health probably shouldn’t use BMI. But, if they want to make predictions about future health risks, BMI might be a helpful tool.

h/t @qz

Stop counting blueberries

I was excited to hear that Sandro Galea took the mantle at the Boston University School of Public Health. I’m more excited that he’s using that perch to shape discussions about how we can improve the public’s health.

Far too much university research and funding, Dr. Galea said, is dedicated to making increasingly precise tallies for relatively minor issues. Instead of paying researchers to count how many blueberries per day may cut the risk of heart attacks, Dr. Galea said, universities and their funders could more systematically identify and tackle the root causes of social problems — such as tolerance of violent attitudes, indifference to environmental concerns, and large and persistent gaps in wealth, education, and economic opportunity.


This is why it’s so hard to launch a health app

(Or any other app for that matter)

Nielsen just announced its list of 2015s top 10 smartphone apps. [Not] surprisingly, all 10 of the apps hail from just 3 companies: Facebook, Google and Apple.

I’ve been a bit of a broken record about this lately, but it’s becoming hard to ignore the obvious: it’s hard out here for an app.

There are no health apps, no apps from startups, and none that rely on connected devices. Given the challenge of getting and retaining users, most of us who create digital health approaches need to identify new routes into consumer’s hands. Looking for some ideas? Start here.

Chatting about digital health and food at James Beard

I had a great time at this year’s James Beard Foundation Food conference — what an amazing group of food thinkers and makers. My panel, Health or Hype: Dealing with Information Overload, was particularly fun (and stocked full of Dukies — 3 of us). Check out the video.

Do this in your next health app

(It’s funny how far we haven’t come, no?)

Hoping to build search interface on your new health app? This should be your inspiration goal.

Forget all that you can do with a quantified self-style interface. People want answers. Not more numbers, figures, charts, and talking avatars. Imagine an interface that allowed people to ask things like:

  • Am I exercising enough?
  • How long is it going to take me to lose 10lb?
  • How much weight should I lose to get off this blood pressure pill?