Clinicians know that increased BMI influences numerous disease states, with ongoing research being performed to define the pathophysiology of such conditions. Literature has shown associations between BMI and cancer growth at a cellular level and association with other disease states. These cut-off points were discussed in the prior section. The WHO has addressed this issue and has recommended modified cut-off points for BMI categories in Asian populations. Several studies have shown that Asian populations exhibit a higher overall body fat and increased cardiovascular risk factors at lower BMI values than white populations. Īs weight fluctuates within the critically ill population (typically decreased weight), it is not useful to utilize the BMI of these patients to guide treatment options or future outcomes. That said, clinicians must immediately address unexplained weight loss within this population to identify potentially modifiable causes. Instead, there is an increased mortality risk for those elderly individuals with a BMI at the low end of the recommended BMI range (BMI <23.0 kg/m 2). In the elderly population, being overweight is not associated with increased mortality risk. Simply put, this study demonstrated that BMI is beneficial when determining a patient to be obese but can give false data when determining a patient not to be obese. This study showed that BMI-defined obesity is highly specific (99% for women and 95% for men) but shows poor sensitivity (49% for women and 36% for men). One study of 13,601 subjects found that BMI-defined obesity (BMI ≥30 kg/m 2) was present in 31% of women and 21% of men, while body fat-defined obesity was found in 62% of women and 50% of men. It is also essential to understand that BMI has limited value in evaluating bodyweight health in people of short stature and does not account for differences in body types between men and women. Of concern is that with this normalization, the equation distributes equal mass to each height level, which subtracts from the utility of BMI in studies of differing body types. However, BMI has no way to account for this variable. In the calculation of BMI, height is squared to reduce the contribution of leg length in taller people, as most body mass remains within the trunk. Individuals with abdominal (visceral) obesity are at a greater risk of acquiring multiple pathological conditions and have a higher morbidity and mortality rate. BMI tends to overestimate body fat in those with a lean body mass (eg, athletes or bodybuilders) and underestimates excess body fat in those with an increased body mass. BMI can indicate the relative amount of body fat on an individual's frame but does not directly calculate body fat percentage.
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