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I'm currently 5'9", 262.8 at last weight in (about 10 days ago). I'm still cutting, by no means am I 'obese', although that's what my BMI says. I have plenty muscle mass, but to be honest I could stand to lose a few pounds (got married, stop lifting, etc). At my best physique I was between 175-195, and BF% floated between 7-10%.

The downside of that is, according to the blanket bmi chart

I'm dangerously obese, and even at my top physique I not even close to the target range (160 is definitely out of the question).

My health insurance provider (among other companies) regard BMI as the end all be all of healthiness, which is certainly not the case. So, my question is: Has anyone been able to talk with these companies regarding this? I know I'm taking a chance with this being off topic, and that's fine (we need off topic examples anyway) but I know I'm not the only person in this dilemma.

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I think you misunderstand the term 'obese' and the use of the BMI scale. Most people picture very large and fat folks when they hear 'obese', but that is just one example. See my answer below. –  Ryan Miller May 9 '13 at 15:13
    
What other data do you have? Marathon/10k times? Lift numbers? VO2 max? How can you demonstrate your being in great shape to them? –  Kate May 9 '13 at 16:16
    
I have lift numbers. I could also show/demonstrate mile times, and also BF% once I finish cutting. @Kate –  BigHomie May 9 '13 at 16:19
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@MDMoore313 What kind of fat measurement technique was used, and when was the last time you had it done? And if your "best physique" was in the 185 range at 7-10% bodyfat, then at 80 lbs heavier, I would easily believe you fit into the obese category. For comparison, a quick review of top competitive bodybuilders, their competition weight ranges from 230-250 on average, with off season weight in the 250-270 range. Do you really carry as much muscle mass as a competitive bodybuilder? If not, take an honest look in the mirror, not a hopeful one. –  JohnP May 9 '13 at 16:26
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What evidence do you have that you are in "great shape"? Resting heart rate is one indicator. Men's Fitness mag publishes benchmarks for fitness; you may want to look at some of these. –  Mho May 9 '13 at 16:44
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4 Answers 4

up vote 6 down vote accepted
  1. Medical Checkup

    The best way to convince your health insurance provider that you are in great shape is to show them the results of your physical exam showing that you pass with flying colors. Your medical doctor would be the one to determine whether or not you are healthy.

  2. BMI is a screening tool - NOT a diagnostic tool.

    As stated by the CDC:

    BMI is used as a screening tool to identify possible weight problems for adults. However, BMI is not a diagnostic tool. For example, a person may have a high BMI. However, to determine if excess weight is a health risk, a healthcare provider would need to perform further assessments. These assessments might include skinfold thickness measurements, evaluations of diet, physical activity, family history, and other appropriate health screenings.

    Given that I am not a doctor and cannot give you medical advice I can't tell you which tests would show that your are healthy. Some of the tests your doctor performs will show if you are at higher risk for heart disease and other health conditions. According to the National Institute of Health risk factors include:

    •High blood pressure (hypertension)

    •High LDL cholesterol ("bad" cholesterol)

    •Low HDL cholesterol ("good" cholesterol)

    •High triglycerides

    •High blood glucose (sugar)

    •Family history of premature heart disease

    •Physical inactivity

    •Cigarette smoking

    So having normal blood pressure, good cholesterol levels and ratios, normal blood glucose levels etc. could give your insurance diagnostic tests indicating your health.

  3. Waist Measurements

    Waist measurements are another part of the assessment. The more weight you carry around the middle, the more your heart health is at risk. Measure your:

    • Waist circumference
    • Waist to Hip Ratio
    • Waist to Height Ratio

    Ideally your waist circumference should measure half your height or less. Your waist to hip ratio should fall between .9 to 1.0 for men and .8 to .85 for women. Waist circumference can be used as and indicator of obesisty with measurements determined as follows:

    • Men — Greater than 40 inches (101.6 cm) are obese
    • Women — Greater than 35 inches (88.9 cm) are obese
      (These values can be even lower depending on ethnicity.) Our site has a page on waist measurements and ratios.

    All of the above, combined with a healthy body fat percentage can help you determine your health risks. If these values are in the healthy range, you have good data to give your health insurer or other companies. If these values are not in the healthy range then see @JohnP's comment :)

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BMI does not work well for people with significant muscle mass.

Go out and get your body fat measured (DEXA or hydrostatic weighing are the best methods). That will give you another bit of data.

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I have not had a discussion with an insurance provider, or had the need to have that conversation. But, I have had similar conversations with similar, physically strong people with regards to BMI.

I doubt any single person will change the health industry from using BMI as a guideline for insurance premiums.

I do not work for an insurance provider, but if we are to use a single measurement of health, there are arguments for using BMI.

BMI is body MASS index. In simple terms, it is simply the effect of your MASS on your heart. Mass is not biased. Two hundred pounds of mass is 200 pounds. There is no difference on the stress of your heart if that two hundred pounds is 4% body fat or 40% body fat. The heart still needs to support the stress of 200 pounds.

Yes, absolutely, 4% body fat is generally better than 40% body fat especially in terms of high blood pressure, blood sugar, etc. But, again, BMI is all about total MASS, not body composition.

I think we are trained, maybe from various media, that the term obese is only associated with high fat and overweight people. But, in reality obesity is simply a measure of mass or BMI.

If again we accept that BMI is a valid measure of simply stress on the heart, then one must agree that the BMI scale is a good single indicator for health insurance companies. With heart disease and heart attacks being top causes of death and other related (high cost) issues in the United States, it's simply a way of filtering the highest risk candidates with the lowest number of tests.

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I guess putting it simply (Effect of Mass on the heart) you make a great argument. –  BigHomie May 9 '13 at 15:17
    
BMI surely isn't "simply the effect of MASS on your heart"--or else why is there a divisor in the equation to take into account height? We already have a way to measure mass only: the kilogram. So why don't insurance companies just use that? Because it's not a good predictor. What you are saying is that someone who is 4'11" and 180 lbs is at similar cardiovascular risk as someone 6'3" and 180 lbs. That can't be right--and isn't. –  Chelonian Jun 4 '13 at 18:35
    
@Chelonian I see your point, but that's not what I am "saying"; that's what you are inferring. Describing it the way I do always makes the light bulb go on in people's heads who are confused as was the OP. Perhaps the height component assumes someone 59" has a smaller heart (size, capacity, strength?) than a 75" person. –  Ryan Miller Jun 5 '13 at 15:19
    
How am I inferring when I am refuting a direct quote of yours? Look up BMI: its intended usage was/is for roughly quantifying body fat composition, not mass. See here: en.wikipedia.org/wiki/Body_mass_index#Usage –  Chelonian Jun 5 '13 at 15:56
    
I am not saying "someone who is 4'11" and 180 lbs is at similar cardiovascular risk as someone 6'3" and 180 lbs." You are inferring that from my post. Either I am describing it incorrectly or you are inferring incorrectly. I am saying that the 4'11" person is at much more risk than the 6'3" - which is what you are saying. And BMI is not about body FAT composition. It is about body MASS composition. BMI does not care whether the 180 lbs is 100% muscle or 100% fat it is still mass. And that is what most people don't understand. –  Ryan Miller Jun 5 '13 at 16:51
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I'm going to buck the trend here and say you need to lose weight - you are not in great shape.

Lets look at a couple of facts.

  1. You are off the scale. Literally. The image you included doesn't go past 250 lbs, you are 262.

  2. Jay Cutler, professional body builder and competes at 274 lb with an off season weight of 310 lb. You are close to these figures, but I somehow doubt you are a professional body builder.

  3. You were 195 lb at 10% body fat. This gives you about 175 pounds of muscle. You say you've been pretty lax with your diet and exercise, so lets assume this has stayed the same. At your current weight that makes you about 33% body fat. Assuming you grew muscle up to 195 pounds, thats still 25% body fat. In either case, these are far too high.

BMI works as a diagnostic tool, and while it underreports at low fat it usually very accurate at determining high body fat.

Conclusion: Based on your own self-reported data you are overweight and are not in great shape.

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