Wednesday, February 10, 2016

Weight, BMI, BF% - Should MDs Measure Things That Shouldn't Change Treatment?

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Something I struggle to understand is the medical community's (and much of the public's) use of some combination of weight, body mass index, body fat percentages, or waist circumferences as a means to determine whether or not a person might benefit from an exploration of their lifestyle.

While all of those measures to a degree do inform risk, are they really useful to the clinician in determining the need for the exploration of a person's lifestyle? Does it simply follow that if one or more of weight, BMI, body fat percentage, waist circumference or waist to hip ratio is high that said person's lifestyle isn't healthful, or that treatment (lifestyle, meds, or surgery) is required?

A more important question though would be if all of those numbers were in so-called healthful ranges, does that mean your patient's lifestyle shouldn't be explored?

I know plenty of people with weight whose lifestyles are tremendous, and plenty of folks without whose lifestyles are horrifying, and as such, regardless of numbers, clinicians are best to explore lifestyle with every single patient. Artificially hinging a discussion on lifestyle on a number which even with the best of intentions and efforts, might not change much, can both lead a person to abandon their efforts to live more healthful lives when things don't change, and preclude conversations that in turn might benefit your patients and their families.

The goal is the road (a healthful one), there is no destination (the numbers).

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