How Body Mass Index Affects Health - A-Z of the NHS - Dr Gill

[@captblk]

Who knew that the prospect of calculating BMI in his head would get Dr. Gill so animated!? Loved that moment! And as always, a wonderfully informative video.

[@DrJamesGill]

The geek is strong in me! 😊

[@manny_f]

I lost 40 pounds of body fat by counting calories to limit my caloric intake and doing a bit of exercise every day (cycling to work). The key really was counting calories. In our society food is readily available and we need to learn to limit the amount of calories we consume. It's crazy how easy it is to mis-calculate calories and therefore put on weight. The most important thing I learnt was that feeling hungry doesn't mean you are not getting enough calories, it just means, potentially, that what you've eaten is not satiating enough.

[@jaredknight]

This is a topic Im very interested in. Living in America we have an even worse problem with eating disorders. I believe its about 66% of Americans are either overweight or obese. I used to think as a child that those who were overweight and obese simply didnt exercise enough and I thought they were lazy with little self control. As Ive gotten older Ive come to realize the factors that can contribute to an individual being overweight. Im glad you have mentioned things like depression as a contributing factor. Its very sad how people can become overweight and obese and I wish there were easy options for them to become a normal weight. Sadly a percentage have to turn to risky surgeries like you mentioned or risk never losing the weight. Thanks for the video

[@DrJamesGill]

I think this is why it is reasonable to describe obesity as a disease, there are so many factors, that patient may not even be aware of With health and personalised interventions, people are able to overcome obesity, but it is a very difficult journey I can’t stress it enough, there is not a one size fits all approach, and that has been the issue with current approaches

[@alliee2877]

Good evening Dr. Gill, thank you for this video. I was disappointed that the category of being 'underweight' and it's associated health risks was omitted from this video. As someone with a BMI currently below 15.5 I feel that the health risks of being underweight are largely omitted from popular societal discourse. This omission and the narrative that there's no such thing as 'too thin' within parts of society (not this video specifically of course) reflect how difficult it is to communicate the severity of risk associated with being underweight, especially in terms of heart, bone, hormonal and reproductive health. By focusing the narrative on the negative health outcomes associated with the higher end of the weight spectrum it can be difficult for people who are underweight to fully understand or believe the severity of risk associated with being even only slightly (let alone severely) underweight which can hinder their ability/willingness to seek or accept medical help. Now I understand this video was intended for a broad audience to whom the obesity messaging is more applicable and in general stands to do more good. I'm used to putting my personal feelings aside in order to support what will help the 'greater good', however I must say it stung to see this video ignore the issue of being underweight. I admire your videos and was really hoping you'd cover this topic with the balanced and nuanced approach which you usually employ. You say in the video that "when something becomes normal it's hard to see that it's a problem" and I would say that in addition "when it's not spoken about its hard to see that it's a problem" too. Thank you again for the videos and I hope you take my comment on the constructive spirit in which it was intended.

[@DrJamesGill]

I actually agree with you. It was an intentional choice. Only having so much time, to focus to the higher levels of BMI I have no intention of diminishing the issues associated with low BMI - I have personal connections to the topics, which I hope you appreciate I don’t think currently it’s something I’d be able to go into, but sufficient to say - I completely understand the risks and health issues with it It’s something that it would be good to address in future, but in a very sensitive manner, and with the focus on this video, I felt it could have been seen as a poor juxtaposition

[@alliee2877]

Thank you Dr Gill, I really appreciate your response and the sensitivity with which you approach this topic. You make an excellent point about the potentially jarring or inappropriate juxtaposition which may have resulted from covering both topics in this video which I hadn't previously considered. I look forward to your future videos and thank you again for all you do.

[@DrJamesGill]

👍

[@defaultytuser]

I once experienced this in a rather odd way. During a medical examination to revalidate my pilot's license I got an "approved" calification while being underweight (albeit with a little scolding from the examiner). My dad, who was also having the exam on the same day and place than me, got a "rejected" calification for being overweight. The curious thing is that his deviation from the healthy threshold was waaaaaaaaay smaller than mine, yet he got rejected and I got a pass. At the time I assumed it wasn't as linear a scale as it seemed (for eg, taking into consideration age, body fat, etc ) But still, ever since I wondered if it was merely a matter of social construct or if there is actually a medical reason by which a mildly overweight person is more prone to suffering health issues than a moderately/severely underweight one...

[@DrJamesGill]

There is certainly more evidence to support overweight having more health issues or risk of at least than mildly under weight. I don’t do airplane Medicals, so I’ll have to look and see if there are any cutoffs

[@starfishgurl1984]

I’m really happy to see that mentioned because I was the smallest of my siblings at birth and I was almost 9 Lbs. (4.082331 kg) so our bodies are somewhat built like solid muscular tree trunks which completely alter our BMI results because it fails to take bone/muscle mass in proportion to the amount of fat for our size/frame into account so I’ll always be seen as overweight according to my BMI even if health wise that’s not actually the case. That being said there was a time when I was overweight/obese and that’s because I didn’t know about the existence of the terms for asexuality, aromanticism, demigenders, and sensory and auditory processing disorders despite struggling with all of those so once I finally discovered them my mental health completely changed and my weight loss soon followed as a result. Great topic!

[@ericterrell7486]

Love Dr. Gill.

[@DrJamesGill]

👍

[@Monolith05]

This is a wonderful insight into metabolic and weight problems. I'm strongly agree with the stigmatization that society has on weight issues and what some mental illnesses can lead, but it is also curious how some people within society tend to normalize and see with acceptance "being fat" after all the problems and bad outcomes that resulted from bullying. Now it is more common to hear parents saying to their kids to love as you are, your weight is ok (being overweight or obese) . As medical professionals we have to implement an educational consultation on our daily routine to patients and to not see this "normal". These issues still killing people worldwide. Greetings and very nice job colleagues. Keep it up!

[@DrJamesGill]

I think education for us is a big part. We have whole LECTURES on helping people stop smoking, with evidence base on how to phrase those questions and comments. Those same resources are not as widely ingrained for weight assistance

[@asahk7419]

- exercise so that you feel better, have more energy, and more joy in life... I've heard this many many many times. I've heard it too much. In fact, I'm gonna get angry at the next person who says this to me. I don't feel good after exercise. I feel like dying. I sleep 4 hours afterwards. I can't stand, focus. I feel light headed and I just don't feel good. I've never felt good. I got a personal trainer, so I know I'm doing it right... but I still don't enjoy anything about it. I dread it every single time. I dread the whole workout time, and what comes after it. It takes so much time for me to recover, I'm actually thinking of stopping it...

[@Cbd_7ohm]

My favorite exercise is skateboarding because that’s my sport. I can relate though.

[@kristiandepue5374]

This was very interesting to listen to, but I was distracted by Dr. Gill's shoes. I want those kicks.

[@DrJamesGill]

Simple pair of Clarke’s. I have a rule of thumb for all shoes - as a consequence of working bit hospitals - always has shoes you can run in without worrying

[@laurenhw1988]

Whilst I think BMI is certainly a good tool for many, I do think there is not nearly enough attention paid to body type. For example my body fat is low for a woman, my muscle mass is in the high range. My body type is definitely more muscular but I'm in no way an athlete or body builder. I work out for an hour 3 to 4 times a week and am very fit. I'm a size 10 on top and size 12 on my bottom (I'm naturally very hippy). And yet my BMI is 27, putting me well into the overweight range.

[@aeward1982]

I find the bmi thing a bit odd. I'm about 10 stone and only 5ft 2 and apparently - overweight. I'm a size 10 on the bottom, size 8 on the top. As you can see from my profile picture, taken last summer, I'm not what anyone would look at and say that I needed to lose weight. I'm active, enjoy walking and biking, kayaking etc.. I have felt my middle is a little heavier in the last year, I'm a mum whose getting towards 40. I used to be able to eat whatever I liked and not put on weight and I recognise that isn't so much the case in the last 5 years or so. I feel for the nhs bmi index to call me overweight is a bit of an insult to be honest. I'm glad I'm not the sort to take it too much to heart as I know, for me, I'm an ok weight and I don't feel I look fat. I don't do diets.. I don't know why anyone would be so strict and make themselves miserable and guilt ridden, I just eat sensibly and get out and about.

[@neus8383]

So we could say thay the % of body fat is a much better indicator of health that BMI but measuring it at home is a pain. Do you have any recommendations to measure it at home?

[@DrJamesGill]

Absolutely. Body fat % is a far superior measure. Unfortunately getting an accurate measure at home is hard. There are plenty of body fat scales - Withings and Garmin are two good types My feeling there is the numerical value is likely erroneous, but the measurement will be accurate. So if you know you are over weight, and the scales say your body has is 15 red apples. The red apple but doesn’t matter, what matters that you work to lower the number. I hope that makes sense. I don’t have the statistical vocabulary here

[@howardasternfan]

I'm currently dieting. I've tried multiple times the low carb one with only short term results. I've discovered intermittent fasting. I started a month ago. It's the first time in 10 years I've been below 200 lbs. I'm down about 15lbs with 25 more to go. Good luck to all that are trying. It's tough but you can do it.

[@DrJamesGill]

Excellent! Very pleased for you Intermittent fasting looks very promising, esp as it is utilising how our metabolism works rather than just how modern life works

[@laurafowler-nichols7828]

I can't wait to watch this. I'm interested whether you cover the fundamental lackings of BMI. As always grateful for everything you do

[@laurafowler-nichols7828]

And yes you do. It is a crude number and frustrates me, whilst I can still appreciate that as a very, very basic tool it can have a function

[@randomuploadsism]

Laura Fowler-Nichols Yes but it’s a function that some doctors got too hung up on..... in shows like Supersize Super Skinny they go on and on about it like it’s a magic number. It’s just a scale someone came up with.

[@rebeccaturner1662]

A very interesting and informative video, thank you, Dr. Gill! My BMI is at 16.8 which I believe is considered underweight. I do however have EDS, not sure if that is a factor.

[@laurenclark1480]

Mine is zero. Sick for a year with no answers. Terrified. 90# 5'6"

[@celinhabr1]

Very important. Thank you.

[@DrJamesGill]

👍

[@3jdbaidn]

Will the B12 video be uploaded shortly or am I missing where the link should be? Thanks so much for these videos!

[@DrJamesGill]

It’s coming. The process happened to spit this out first

[@3jdbaidn]

@@DrJamesGill looking forward to it!

[@shawndavis9000]

Hey doctor can a urologist tell if you have scar tissue or damage in penis from priapism with just a hands on physical examination i went to a urologist who examined me like that and he said im good. But online it says you need a ultrasound but he said i dont need anything

[@anarup24]

BMI is a load of rubbish imo, especially when I comes to polynesians. I have a flat stomach,large chest, 20inch calf muscles and tree trunk thighs but I am "morbidly obese". I would guess my body fat is near 12-15% but BMI indicates I would need to lose weight or that I ammat risk

[@DrJamesGill]

You’ve made the point there. You know your body fat percentage. This is a MORE accurate assessment for risk calculation. That doesn’t mean that BMI is a bad estimator, it just means that we have to understand who we are calculating the risk for. BMI by that same measure is a better metric than simply weight alone. What matters when thinking about tools is HOW you use them, and in which situations it’s wrong to use them Let’s assume 1% of people rated obese, are actually body builders, sports people etc. BMI is an incorrect tool for them. HOWEVER by those people saying “This is rubbish IMO” it undermines the efforts to try and help the people that DO need to hear their BMI is putting them at risk “This fork is rubbish for eating my soup” means that the wrong tool is being use for the job, it doesn’t mean that the fork is rubbish

[@oiitssean]

Unless you have had it measured, I guarantee your body fat is higher than you think. Was a PT for a while and every single person who wanted it measured massively underestimated their body fat percentage. Also every polynesian I have known and trained was big but carried more bodyfat than average. Idk if it's the polynesian diet or genetics.

[@time_for_toast4922]

I'm a bit ashamed to admit that I eat quite unhealthily. However, I'm only slightly overweight. Actually, since I've never gotten a BMI, I am actually on the heavy side of the 20-25. So technically not. And that's because my job is construction. Meaning five days a week I do much physical labor, so my body can't get overweight with all that burning of calories. However, I've noticed a distinct lack of energy toward lunch daily now. And I know it's because carbohydrates and sugars.

[@Xepscern]

Is there any difference between how high a BMI is after 30? My BMI is... quite high, and Im unsure how urgent it is for me to see a doctor about it

[@DrJamesGill]

It’s not urgent, but the best way to think about it is the strain the body experiences. An analogy I like is being obese is like carrying around extra bags of cement in your car. It’s not actually HURTING, and not the end of the world to carry them around for a while, but you’ll probably wear out components in the car sooner over the years, and maybe increase the risk of extra wear and tear your car wouldn’t have normally received. So I’d always advise if some wants to talk about weight loss, they call and talk about weight loss. The worst outcome if you feel that 10min consultation wasn’t what you’d hope it would be

[@Xepscern]

@@DrJamesGill thank you for the response. I actually... this was my original question, I just did a terrible job wording it. Are there any other classifications for BMI after 30+ meaning obese? To be blunt, what makes me worried is that... Im 1.9m, 202 kg. My BMI is 56. And I'm worried what a BMI over 40 or 50 could mean.

[@SparkesIsRunning]

piled on weight since starting amitryptiline for migraine in november! Dont feel hungry so not sure why?

[@DrJamesGill]

Amitryptiline has a large number of side effects. Two of which are altered appetite abs weight CHANGES. Which I think is interesting, as a lot of meds tend to specific weight gain or loss

[@SparkesIsRunning]

@@DrJamesGill definitely a SE for me!

[@DrJamesGill]

I suppose the question then, is does it help?

[@49ers_red_and_gold2]

BMI is rough 😔 Wow Arnold was at 8% of body fat 🤩

[@DrJamesGill]

BMI is reasonable, but extremes, such as Schwarzenegger show there are limitations. Personally I prefer total body fat as a measurement

[@eduardorangel7388]

I lost 30 pounds in 5 months with intermittent fasting. I was on diabetic medication and felt low energy all the time. Intermittent Fasting worked for me. It's easy and cheap

[@eliiiahhh1934]

I feel kinda offended, because he didn't talk about people with lower bmi, like there wouldnt be any people who have lower bmi

[@rhythmknight4158]

Less than 3% are underweight in US hats why.

[@icadoriogorgeousiano9454]

I am 6'1" and 210 lbs. My BMI is 27.7, so I'm classified as overweight (fat). However you can see my abs. But according to BMI I'm a fat slob.

[@aveuch]

BMI is a lot like a credit rating. I can't fit into straight size clothes until I'm less than obese - even though I look and feel average.

[@randomuploadsism]

Obese is average in many parts of the US

[@DrJamesGill]

I’m sorry, I don’t understand

[@joeblogger5687]

Except that the BMI is too often used as an absolute. Numerous doctors will tell you that it should be a general guideline and nothing more: too often the BMI will claim that you are obese, or even morbidly obese, when you are nothing of the sort.

[@DrJamesGill]

That is the exception rather than the rule. For the majority of people, if they are indicated as obese based on BMI, it is something that they should be concerned about

[@joeblogger5687]

@@DrJamesGill. "Except that the BMI is too often used as an absolute". Lots of medical professionals forget to use their eyes and common sense.

[@DrJamesGill]

That doesn’t mean that BMI is any less valid. If someone is struggling using a hammer as a screw driver, the issue is the operator, not the tool. BMI is a validated, effective metric, and is only in accurate in a small minority of patients

[@joeblogger5687]

@@DrJamesGill Nice to have you agree. 😁

[@DrJamesGill]

There are few absolutes. That said, if a patient is calculated as having a raised BMI, there are not many cases when it would be inaccurate in the general population If a patient was calculated as being obese, I would not hesitate to discuss with, and advise them of that fact and the serious health implications associated with being overweight I wouldn’t consider that calculation problematic or that any further investigation was needed with regard to their build unless a patient felt that they were a sportsperson or body builder - as that is an outlier case

[@Sxndro1]

im 23 bmi but i look thinner then i am

[@DrJamesGill]

23 is the healthy range 😊

[@sammuslu2992]

Hello doctor,I'm 15 stone and have a 30" waist,when I input my details in the NHS website for BMI it says I'm morbidly obese 😂,why doesn't it cater for men like me?😭😂😂

[@DrJamesGill]

Well for one thing it is weight and height, not waist size for this calculation. But I assume from your profile image that you are a body builder. Essentially the one group for whom BMI calculation doesn’t work

[@sammuslu2992]

@@DrJamesGill oh I see,i have very little body fat so I just couldn't understand why it said I was morbidly obese 😂 Thank you sir keep up the good work, your channel is very interesting 👌🏽💪🏽

[@randomuploadsism]

As much as I agree that being overweight is unhealthy, the actual values of BMI aren’t based on any actual scientific values - there is nothing that happens when you go from a BMI of 25 to 26 or from 20 to 19. It’s just a sliding scale and those are nice numbers.

[@randomuploadsism]

Not criticising the system but I hope people will understand my point. I personally think bodyfat is a better indicator of health but I suppose that can be tricker to get accurate as it varies depending on the time of day etc.

[@DrJamesGill]

That’s not technically correct. As you could say the same for any similar medical scale As your blood pressure goes up, nothing happens to you immediately, but You would be able to map out increased risk of long term comorbidities

[@ktrigg2]

This will be censored for “fat shaming.” Lol, I love the movement to accept morbidly obese as perfectly healthy.

[@DrJamesGill]

Having had dealings with KZbin, the response don’t seem... thought through, but I would not think there will be an issue here 😊

[@neus8383]

The movement is not to accept it as healthy, it's to accept morbidly obese people as people deserving of respect and loving yourself in spite of having that health problem. Society treats fat people as garbage and you know it perfectly well. Hating and bullying a person is not going to be productive to help them improve their health.

[@user-rd1sz4kk9f]

I am morbidly obese

[@JasonTheOneAndOnly]

Doctors arn't allowed to tell people there to fat tho, facts arn't allowed in today's "society", I realised I was to fat when my liver started hurting cause of a fatty liver, it still does sometimes, even after losing roughly 40kg.

[@DrJamesGill]

I’m pleased to hear that you managed to reduce the weight. The pain can be due to the liver capsule stretching.

[@martinzies2874]

You failed to offer any explanation as to why other peoples perception of overweight people has any bearing on the overweight people...I have heard fat shaming works...is that what you meant? Also, nothing on the origins of bmi who came up with it and how....lazy video at best.

[@DrJamesGill]

I am so sorry for what ever experience you have had which would lead to you feel that fat shaming would have positive effects. Perhaps if we view obesity in the same way we do smoking: That patients have made regrettable decisions in the past, but that talking down to them or trying to shame has only poor outcomes we’d have better outcomes

[@timehealthfit1891]

You're more helpful than you realize, want to be youtube friends?

[@alasdairbaird7303]

The most useless figure in medicine. Only joking. Ex rugger chap. My grandad James Baird practiced in Sunderland. His son - Dad's younger brother also James Baird is 95! Uncle Jimmy wrote Grandad's obituary for the BMJ which appears in the June 1974 edition. Hannah Baird, grandaughter and great grandaughter, studied her medicine at Manchester.