The podcast explores controversies surrounding the hosts' identities. They discuss the limitations of using BMI as a clinical metric and advocate for considering other factors. The speakers also delve into bodybuilding experiences, challenges of peaking for shows, and the discrepancies between lab mice and humans. They touch upon the importance of advocacy, social change, empathy in weight loss journeys, and the impact of weight loss drugs on appetite.
BMI is a flawed metric that does not consider muscle mass and was not originally designed as a nuanced health metric.
Metabolically healthy obesity may be a transient state, and long-term health risks associated with obesity can still develop over time.
Targeting specific BMI ranges as goals for health can be problematic; focus should be on tangible health outcomes and adopting lifestyle changes.
Deep dives
The Limitations of BMI as a Health Metric
BMI is a flawed metric that does not account for factors like muscle mass. It was not originally designed as a nuanced health metric but rather as a population-level indicator of adiposity. Additionally, BMI does not distinguish between fat mass and fat-free mass. There are valid criticisms of BMI, and it is important to acknowledge its shortcomings.
Metabolically Healthy Obesity
Metabolically healthy obesity refers to individuals with a high BMI who do not exhibit the typical metabolic syndrome markers. However, the prevalence of metabolically healthy obesity decreases as BMI increases from the low 30s into the mid to high 30s and beyond. It is important to highlight that metabolically healthy obesity may be a transient state, and long-term health risks associated with obesity can still develop over time.
The Linear Relationship between BMI and Metabolic Syndrome
While there are people in the normal BMI category who exhibit metabolic syndrome markers, the prevalence of metabolic syndrome components generally increases as BMI increases. This linear relationship suggests that higher BMI is associated with a greater likelihood of having one or more components of metabolic syndrome.
The Importance of Focusing on Health Outcomes Rather than BMI Targets
Targeting specific BMI ranges as goals for health can be problematic. It is essential to shift the focus towards tangible health outcomes such as improved glycemic control, blood pressure, and physical activity levels. The highest BMI ever reached in one's life, even if followed by weight loss, does not necessarily eliminate potential health risks. The emphasis should be on health promotion interventions and monitoring relevant markers rather than solely targeting a specific BMI range.
Weight loss as an intervention
Weight loss should not be seen as the only measure of success when addressing elevated BMI and metabolic syndrome. While weight loss is beneficial, it is not always feasible or necessary to achieve significant weight reduction. Other health behaviors, such as exercise, diet improvement, and sleep, can lead to improvements in cardio-metabolic health markers, even without substantial weight loss. The focus should be on overall health and adopting lifestyle changes, rather than solely fixating on achieving a specific BMI or weight goal.
The role of BMI and prevention
BMI can serve as an indicator for potential health risks and can be useful in identifying the need for further testing and interventions. However, it is important to view BMI as a tool for prevention rather than solely focusing on weight loss. Tracking changes in BMI over time and adopting behaviors that promote health, such as regular exercise, balanced diet, and healthy lifestyle habits, can help prevent the accumulation of chronic disease risk factors. The goal should be to manage cardio-metabolic health markers and make meaningful strides, even if significant weight loss is not achieved.
It’s Eric-ception folks. Today, we put to bed two controversies. Not only the controversy as to whether or not Eric Trexler is vat-grown, as he seems to have at least SOME pop-culture knowledge, but also the controversy of whether or not Eric Trexler and Eric Helms are actually the same person. The last two episodes renewed this conspiracy theory due to the occurrence of the “new” host Eric Trexler being on the last two episodes, while Eric Helms conveniently could not be on at the same time. Well folks, this episode, both Erics are here, and boy do they deliver.
Dr. Trexler does a deep dive on the topic of BMI, which has come under substantial fire in recent times due to its shortcomings as a useful clinical metric. But should we abandon it completely? What can BMI tell us? What can’t it tell us? And, how should it be used, if at all, moving forward? And, where do we find the middle ground between advocacy and scientific accuracy? Tune in to find out!
00:00 Introduction to the holy trifecta and Eric’s return
21:20 The background of BMI and metabolically healthy obesity
Marcus 2023 Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender https://pubmed.ncbi.nlm.nih.gov/37237531/
40:00 The value of this research from a sociological lens
1:04:55 Goal orientation: changing health behaviours vs reducing BMI
Oscarsson 2020 A large-scale experiment on New Year's resolutions: Approach-oriented goals are more successful than avoidance-oriented goals https://pubmed.ncbi.nlm.nih.gov/33296385/
