Here’s a scenario for you: You go to the doctor for a “regular checkup.” You’re not sick. In fact you feel great. You go for a walk every day and you play tennis twice a week. You eat real food. You don’t smoke or drink. You don’t have high blood sugar, high blood pressure, or high cholesterol. You are over 40 though, and the doc uses that as an excuse to run every test under the sun “just in case.”
Of course everything comes back clear. You’re the picture of shining good health…or so you think. But you can’t escape the clutches of Big Medicine that easily, and your doctor tells you that you need to have a conversation about your weight.
You’re confused. Your weight is well within the normal range. Your BMI is 19, also well within the “healthy” part of the scale. Your waist is slim, and though you don’t have “rock-hard abs,” you’re far from having a beer belly. You’re certainly not underweight either. So what could there possibly be to discuss about your weight?
You’re convinced that you must’ve heard wrong, or that the doctor has been looking at the wrong chart when he tells you that technically, you’re obese.
Wait. What? How can you be obese with a normal waist, a normal weight and BMI that falls squarely in the middle of “healthy?”
The doctor shakes his head sadly. It’s a silent epidemic, he says, and it’s growing worse by the day. They’re calling it—get this—Normal Weight Obesity, or NWO, and more than half the “healthy” weight people in the country have it. One of the tests he sent you for was a Dexa scan, which was originally used to check bone mineral density. Now it’s being used to measure the percentage of body fat a person has, and you clocked in at 20.1 percent. You may look fine, he says, but really, seriously, you’re obese.
Are we really getting fatter, or are they just changing the rules?
Sadly, this isn’t a made-up story, and it isn’t an April Fool’s joke. “Diagnoses” like this are all too real and might be coming soon to a doctor’s office near you if Big Medicine has its way. In fact, “Normal Weight Obesity” looks poised to be the next big “public health crisis.” Heavy-hitters like the Mayo Clinic support the concept, and the fear machine is gearing up to turn it into a “condition” that needs “treated.”
Just to give you a rough idea of what 20% body weight means: if you’ve ever seen a serious cyclist—someone who competes, even an Olympic athlete—then you’re looking at about 15% body fat on average. A professional wrestler might have 16% body fat. I personally know Crossfit athletes—and if you don’t know anyone who does Crossfit, it’s one of the most grueling types of sport or exercise around—with bodies that most people would kill for who’re sitting squarely at 20% body fat.
Even the American Council on Exercise says that 18-24% for men and 25-31% for women is average, while they define “fit” as 14-17% and 21-24%, respectively. That puts 20% for men squarely in the middle of average.
Big Medicine, however, has other ideas. They want to drop the definition of “obese” down to anything over 20% for men or 30% for women. That would, as the hypothetical doctor in my story above says, label over half of us who are firmly in the middle of “normal” not just as overweight but as obese. And if this seems like déjà vu, that’s because it happened before, back in 1998.
The great BMI boondoggle of 1998
That’s when the acronym “BMI” found its way into everyday language. In 1998, the NIH adopted the BMI scale as the way medicine should decide who was or wasn’t overweight, and “healthy” weight dropped by a shocking ten pounds. Literally overnight, millions of people who went to bed with a “healthy” weight woke up to find themselves labeled “overweight,” while millions more suddenly went from “overweight” to “obese.”
At the time, there were plenty of critics of the idea, even within medicine. They worried that people who were very muscular or had large frames would incorrectly be labeled obese. They were concerned that Big Pharma would use it as a way to push diet drugs. (And they tried, but thankfully there have been few diet drugs that actually made it to market and even fewer whose side effects people are willing to tolerate.)
1998 was also when the American Heart Association added obesity to its list of risk factors for heart disease, and that meant they had to drum up lots more “obese” people to make the numbers fit and to sell drugs. So boom! Suddenly half the population became fat.
How very convenient.
Same song, different verse?
I think we’re at the same kind of point now with the whole idea of “normal weight obesity.” There’s a huge, possibly unstoppable push to label obesity a disease. If it’s a disease, then doctors will be expected to “treat” it, not just tell us to exercise more or eat real food. No. If obesity is a disease, then some bureaucrat will create a rule saying they have to “screen” everyone for obesity if they want to get paid. In fact, some insurers are already doing this.
And if we accept the idea of “normal weight obesity,” that “screening” will mean a pricey body scan that exposes us to full-body X-ray in order to calculate our actual body fat percentage. And you can bet your life your doctor will prescribe a handful of pills. Those pushing the idea of “NWO” say that it ups your risk of the alleged “metabolic syndrome” (which is itself merely a collection of other risk factors), so expect to see doctors prescribing blood pressure pills, diabetes drugs and more for perfectly healthy people with a body fat percentage over 20.
Here’s my advice: if you’re a normal weight with a normal BMI and your doctor tries to tell you you’re obese, tell him to take a hike. Better yet, hike yourself over to a new doctor.