I saw this link on Tiptoe's blog and let me just say: I love it, I love it, I love it!

This should be required reading for any health journalist who uses the letters "BMI" in a story--which is basically all of them.

In its entirety (because it's just that good) is the "Top 10 Reasons Why the BMI is Bogus":

1. The person who dreamed up the BMI said explicitly that it could not and should not be used to indicate the level of fatness in an individual.

The BMI was introduced in the early 19th century by a Belgian named Lambert Adolphe Jacques Quetelet. He was a mathematician, not a physician. He produced the formula to give a quick and easy way to measure the degree of obesity of the general population to assist the government in allocating resources. In other words, it is a 200-year-old hack.

2. It is scientifically nonsensical.

There is no physiological reason to square a person's height (Quetelet had to square the height to get a formula that matched the overall data. If you can't fix the data, rig the formula!). Moreover, it ignores waist size, which is a clear indicator of obesity level.

3. It is physiologically wrong.

It makes no allowance for the relative proportions of bone, muscle and fat in the body. But bone is denser than muscle and twice as dense as fat, so a person with strong bones, good muscle tone and low fat will have a high BMI. Thus, athletes and fit, health-conscious movie stars who work out a lot tend to find themselves classified as overweight or even obese.

4. It gets the logic wrong.

The CDC says on its Web site that "the BMI is a reliable indicator of body fatness for people." This is a fundamental error of logic. For example, if I tell you my birthday present is a bicycle, you can conclude that my present has wheels. That's correct logic. But it does not work the other way round. If I tell you my birthday present has wheels, you cannot conclude I got a bicycle. I could have received a car. Because of how Quetelet came up with it, if a person is fat or obese, he or she will have a high BMI. But as with my birthday present, it doesn't work the other way round. A high BMI does not mean an individual is even overweight, let alone obese. It could mean the person is fit and healthy, with very little fat.

5. It's bad statistics.

Because the majority of people today (and in Quetelet's time) lead fairly sedentary lives and are not particularly active, the formula tacitly assumes low muscle mass and high relative fat content. It applies moderately well when applied to such people because it was formulated by focusing on them. But it gives exactly the wrong answer for a large and significant section of the population, namely the lean, fit and healthy. Quetelet is also the person who came up with the idea of "the average man." That's a useful concept, but if you try to apply it to any one person, you come up with the absurdity of a person with 2.4 children. Averages measure entire populations and often don't apply to individuals.

6. It is lying by scientific authority.

Because the BMI is a single number between 1 and 100 (like a percentage) that comes from a mathematical formula, it carries an air of scientific authority. But it is mathematical snake oil.

7. It suggests there are distinct categories of underweight, ideal, overweight and obese, with sharp boundaries that hinge on a decimal place.

Insurance companies sometimes charge higher premiums for people with a high BMI. Among such people are all those fit individuals with good bone and muscle and little fat, who will live long, healthy lives during which they will have to pay those greater premiums.

9. Continued reliance on the BMI means doctors don't feel the need to use one of the more scientifically sound methods that are available to measure obesity levels.

Those alternatives cost a little bit more, but they give far more reliable results.

10. It embarrasses the U.S.

It is embarrassing for one of the most scientifically, technologically and medicinally advanced nations in the world to base advice on how to prevent one of the leading causes of poor health and premature death (obesity) on a 200-year-old numerical hack developed by a mathematician who was not even an expert in what little was known about the human body back then.

Note: if you click on the story link, you can listen to the NPR segment as well.

Let the statistics tell the story:

What's worse, being obese or suffering from anorexia nervosa? People we asked on the street responded "being obese."

But that's not true.

Medically, more people die from anorexia: 20% of people die from the psychological disorder where as an obese woman at 25 still only has a .01% risk of death.

And there's all of this hysteria about obesity and not a whole hell of a lot about eating disorders, which really makes me scratch my head. You're 2000 times more likely to die from anorexia than obesity. An eating disorder triggered by misguided "obesity prevention" efforts isn't a side effect, it's not an acceptable casualty.

It's deadly.

What is a majority of people? Technically, it's a portion that contains more people than not. So anything about 51% or above would be a majority.

Then why would Remuda Ranch consider 49% a majority?

In their recent press release, RR said that the majority of women they treated (49%) had suffered childhood sexual abuse and trauma. I know it's a bit nit-picky, but still. It's NOT a majority.

Of course, RR isn't necessarily in the business of statistics. They're in the business of selling eating disorder treatment programs (at the cost of about $2000 per day). I know people who have gone onto recovery after a stay at RR- but not at the rate of 95% that their website claims.

Still, the issue of CSA in people with eating disorders is, sadly, very real. Could people with eating disorders be more likely to have been abused? Perhaps. But there aren't solid numbers on it. What appears to be the case is that CSA increases a person's risk for all kinds of brain diseases, eating disorders included. It's an incredible stress, and an incredible trauma on a growing brain.

It's a trigger, but it's not necessarily a cause.

I think you need the wiring to develop an eating disorder, period. Does abuse mean your wires may need less triggering than if you hadn't been abused? It seems likely.

But for Remuda to say that the majority of women with eating disorders have been abused or traumatized is WAY off the mark. Remuda does NOT see an even cross-section of people with eating disorders. They see the people who have decided to come to their clinic- and can afford to do so.

It's bad science, and a really tacky PR ploy.

I was reading an article on eating disorders in middle-aged women when I found a sidebar with these statistics:

· Twice as many people suffer from anorexia as Alzheimer's disease, yet Alzheimer's research receives 50 times more funding.
· Anorexia nervosa has the highest premature fatality rate of any mental illness.
· The average American woman is 5-foot 4-inches tall and weighs 140 pounds. The average model is 5-foot-11 and 117 pounds.
· Most fashion models are thinner than 98 percent of American women.
· 81 percent of 10-year-olds are afraid of being fat.· 35 percent of "normal dieters" progress to pathological dieting.
· 25 percent of American men and 45 percent of American women are on a diet on any given day.
· Americans spend more than $40 billion on dieting and diet-related products each year.
· 40 percent of newly identified cases of anorexia are in girls 15-19 years old.
· Only 6 percent of people with bulimia receive mental- health care.
· General estimates suggest that eating disorders prove fatal for as many as 10 percent to 15 percent of people affected.
· 80 percent of American women claim to be dissatisfied with their appearance and shape, and one in two American women are on a weight-loss diet.
· An estimated 1 in 100 American women binges and purges to lose weight.
· Each day, Americans spend an average of $109 million on dieting and diet-related products.

What is wrongwith us, as a culture, that we would promote such things? People love to say that eating disorders don't happen in countries where people are starving. But guess what- people in America are starving. Only here, we use the euphamism "dieting" for it.