Too Fat for Tesla? (Model X)

[Roentgen]

I think real doctors don't jump into conclusions. As a long time expert internet user I conclude he/she is an impostor...or a doctor who made off topic post.

Back on topic, @spentan's MX is signature X so he had it for a while too. Seems like OP issue should be resolved once seat is replaced.

He didn't jump to conclusions.
Fact: stated 6'9" height, 420 lbs weight.
You calculate BMI from that = 45.
BMI > 30 = obese. >40 = extremely obese.

Overall health is linked to BMI - the higher your BMI, the more likely you will have unhealthy consequences (morbidity).

I also read his response as a warning from someone who spends his professional life taking care of others. (Disclosure: I'm also an MD)

 

[Roentgen]

BMI is based on standardized models. It is NOT a predictor of "fitness." Yes, it doesn't take into account certain body types and lifestyles, but it works well for the average person. And it's one of the only tools we have that is quick, easy, and relatively accurate for the general population. It's not junk science. If you are a far outlier on the scale, there is no disputing that there are unhealthy consequences for staying there.

 

[Cyclone]

While I agree that if someone wants to simply ask the question "are you sure about that?" or "you may want to look into this", that is cool. I think there needs to be a IANYD (I Am Not Your Doctor) like IANYL (I Am Not Your Lawyer). Looking out for each other is part of being in a good community. Instantly saying "you are in trouble" without knowing the person I would think it going too far.

Personally, I am overweight just in the obese category. If someone said "be sure to check with your doctor if this is healthy for you" or something along those lines, I would NOT be offended. However, if someone simply told me "you need to fix this, you are obese" or "you don't care about your health", I would be offended. For reference, I am 235 lbs, 6'0", 34" waist, 46" chest with a broad shoulders and a footballers build. I plan to get back to 195 - 205 lbs, but the last time I was near there, my personal physician explicitly said "Do NOT try to get to 180 lbs or below. For your build and frame, that would be unhealthy. Get to the 190s and stay there."

 

[SageBrush]

BMI is a piss poor way of judging health. You can be sedentary and have a normal BMI, decide to go to the gym, build more muscle, lose fat, end up healthier and have a higher BMI that misleads people that don't understand how bad BMI is as a prediction of someones fitness.

FWIW my BMI is about 24 now but was about 20 before I started working out. My waist size dropped 4" and my chest, shoulders, biceps etc are noticeably more developed.

If all I saw was a high BMI I'd have no idea if the person was an athlete or a couch potato.

BMI is an excellent predictor of obesity in the general population, although occasional exceptions do exist.

If I told you of a group of 1000 random American people with BMI = 30, for every one Rock, how many obese people would you expect ?

On the other hand, if we were comparing one group with a BMI of 20 and another group with a BMI of 21, the predictive value of the test to identify fractional body fat differences between the two groups would be poor.

 

[Roentgen]

Exactly. It's amusing how closely arrogance and ignorance are correlated to junk science - such as what has become referred to as BMI.

New England Journal of Medicine December 2010:
Body-Mass Index and Mortality among 1.46 Million White Adults NEJM

"CONCLUSIONS
In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9."

NOT junk science.

 

[vandacca]

I have a Withings scale that measures BMI, weight, fat mass, lean mass, etc. My BMI has always been on the high end, sometimes just above the normal range. But my fat is always well below the normal range, under 10%. At 5'8", I'm ~155lbs (BMI sometimes > 25) and no one who knows me would ever consider me to be overweight.

The fact is that BMI is only a ratio between height and weight and is an overly simplistic measure of health. While it may help determine health for a large portion of the population, there is still a significant portion of the population where it does not apply. Therefore, IMHO it's too simplistic to be of much value, if it can be wrong so much of the time.

In regards to obesity, check out this Ted Talk by Dr. Peter Attia. Very enlightening.

 

[Roentgen]

I have a Withings scale that measures BMI, weight, fat mass, lean mass, etc. My BMI has always been on the high end, sometimes just above the normal range. But my fat is always well below the normal range, under 10%. At 5'8", I'm ~155lbs (BMI sometimes > 25) and no one who knows me would ever consider me to be overweight.

The fact is that BMI is only a ratio between height and weight and is an overly simplistic measure of health. While it may help determine health for a large portion of the population, there is still a significant portion of the population where it does not apply. Therefore, IMHO it's too simplistic to be of much value, if it can be wrong so much of the time.

In regards to obesity, check out this Ted Talk by Dr. Peter Attia. Very enlightening.

Agree. But we're still talking about the majority of the population. It is the personal physician's role to take all these things into account when counseling regarding health.

But this whole issue stems from a poster saying specifically 6'9" 420 lbs. A follow up poster recommends lifestyle change (which could have been worded with slightly more tact, I'll agree). I know of no scale where this could be considered normal, and challenge you or anyone else to show me I'm wrong. All this argument regarding the validity of BMI for people who fall outside the norms doesn't matter in this extreme case.

It behooves the original poster to consider lifestyle changes which would bring his/her BMI to a number closer to the norm.

EDIT:
Just read the transcript from the Ted Talk.
My take away: We don't fully understand the cause of obesity - cannot just blame on the patient's will and behavior. Yes, completely agree.
Still does not change the fact that obesity, regardless of cause, is linked to high mortality.

 

[systemcrashed]

BMI is a piss poor way of judging health. You can be sedentary and have a normal BMI, decide to go to the gym, build more muscle, lose fat, end up healthier and have a higher BMI that misleads people that don't understand how bad BMI is as a prediction of someones fitness.

FWIW my BMI is about 24 now but was about 20 before I started working out. My waist size dropped 4" and my chest, shoulders, biceps etc are noticeably more developed.

If all I saw was a high BMI I'd have no idea if the person was an athlete or a couch potato.

Since we are choosing to stay off topic somewhat, I'll insert my 2 cents here. BMI is just an index. The density of fat is 0.9g/mL the density of muscle is 1.1g/mL so we are talking about approximately 18% more mass per volume of muscle. The BMI accounts for this and the increase in bone mass as well, that is why at the upper end of the scale a person who is 6'10" can be "optimal" between 180lbs and 230lbs (50lb range) whereas a person who is 5'5" is only optimal between 120lbs and 140lbs (20lb range).

 

[TaoJones]

New England Journal of Medicine December 2010:
Body-Mass Index and Mortality among 1.46 Million White Adults NEJM

"CONCLUSIONS
In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9."

NOT junk science.

Hades hath no fury like a practitioner of western medicine questioned.

BMI has been, is, and will always be an overly simplistic measure of health and wellness.

Fortunately, most doctors, regardless of whether they've finished first or last in their class, and regardless of whether they bother to stay on top of the literature in their respective sub-specialty, tend to consider multiple inputs prior to formulating a diagnosis.

This is especially fortunate since defending BMI as a sole source is about as useful as putting lipstick on a pig.

 

[Roentgen]

Hades hath no fury like a practitioner of western medicine questioned.

BMI has been, is, and will always be an overly simplistic measure of health and wellness.

Fortunately, most doctors, regardless of whether they've finished first or last in their class, and regardless of whether they bother to stay on top of the literature in their respective sub-specialty, tend to consider multiple inputs prior to formulating a diagnosis.

This is especially fortunate since defending BMI as a sole source is about as useful as putting lipstick on a pig.

I'm not defending BMI as the SOLE source for judging health. Please read the above thread with a little more care. In what world do you live in, that a 420 lb individual can be considered healthy? I have supplied a link to research from a reputable source. What have you offered except veiled (and not) insults? Your ignorance and lack of reading comprehension are astounding.

 

[dhanson865]

But this whole issue stems from a poster saying specifically 6'9" 420 lbs.

No actually if you'll reread the thread I was responding to posts 23 and 30 Too Fat for Tesla? (Model X) which refer to a person of 250 pounds as obese and thus linking to a BMI chart as though it is the only measure of fitness/health.

I haven't responded to any posts about 420 pounds at any height, I just responded to posts about 250 pounds and BMI in general.

This is where a non threaded post system causes confusion. We have:

* group 1 talking about 250 pounds vs BMI
* group 2 talking about BMI in general
* group 3 talking about 6'9" 420 pounds vs BMI

all mixed together.

 

[SageBrush]

I have a Withings scale that measures BMI, weight, fat mass, lean mass, etc. My BMI has always been on the high end, sometimes just above the normal range. But my fat is always well below the normal range, under 10%. At 5'8", I'm ~155lbs (BMI sometimes > 25) and no one who knows me would ever consider me to be overweight.

The fact is that BMI is only a ratio between height and weight and is an overly simplistic measure of health. While it may help determine health for a large portion of the population, there is still a significant portion of the population where it does not apply. Therefore, IMHO it's too simplistic to be of much value, if it can be wrong so much of the time.

I'll presume you frequent a gym. Can you think of one acquaintance who probably has a BMI > 30 and is not overweight ?
Put another way, what percentage of the population has your physique PLUS another 32.5 pounds of muscle ? That would be an example of a person who could claim a BMI of 30 despite not being overweight.

 

[Odebek]

New England Journal of Medicine December 2010:
Body-Mass Index and Mortality among 1.46 Million White Adults NEJM

"CONCLUSIONS
In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9."

NOT junk science.

What this really means (and says in the article) is that BMI can be a symptom of being unhealthy, it doesn't mean that high BMI causes disease, but rather higher percentage of people with high BMI's have diseases that cause mortality.

 

[alseTrick]

He didn't jump to conclusions.
Fact: stated 6'9" height, 420 lbs weight.
You calculate BMI from that = 45.
BMI > 30 = obese. >40 = extremely obese.

Overall health is linked to BMI - the higher your BMI, the more likely you will have unhealthy consequences (morbidity).

I also read his response as a warning from someone who spends his professional life taking care of others. (Disclosure: I'm also an MD)

If you are both doctors than you should know that patient privacy is part of your ethics. No commenter on here has publicly requested health-related advice. If you MD's truly felt the need to express your concerns and recommendations to certain posters in this thread, you are more than capable of private messaging them.

 

[alseTrick]

Hopefully Tesla fixes their seats, though. While I do enjoy a good rocking chair, I'm not sure how well it'll work in my car.

 

[Drivin]

If you are both doctors than you should know that patient privacy is part of your ethics. No commenter on here has publicly requested health-related advice. .

Well, lets see what happened here:
someone volunteers information about themselves.
someone commented about that information
OMG privacy violation!!

LOL

These threads are really amusing.
The root cause for the obesity epidemic in the country has nothing to do with fast food or lack of exercise, it is how amazingly quickly people rationalize away the facts:
- "Well, I know an Olympic athlete who is all muscle and he weighs as much as I do and he is really healthy - so weight has nothing to do with health!"
- "BMI isn't the only factor since you also need to look at the Hendricks/WIlliams scale of fat absorption, so the fact that my BMI is 45 and I way 350 pounds, could mean that I am actually healthy"
- "I know someone who had a low BMI, exercised all the time, was apparently healthy - but died of heart troubles (he was shot in the heart during a robbery), so my high BMI and lack of exercise already has me living longer than they did".

I wonder what the correlations are between fat-denialists and global-warming denialists and other denialists.

 

[alseTrick]

Well, lets see what happened here:
someone volunteers information about themselves.
someone commented about that information
OMG privacy violation!!

LOL

These threads are really amusing.
The root cause for the obesity epidemic in the country has nothing to do with fast food or lack of exercise, it is how amazingly quickly people rationalize away the facts:
- "Well, I know an Olympic athlete who is all muscle and he weighs as much as I do and he is really healthy - so weight has nothing to do with health!"
- "BMI isn't the only factor since you also need to look at the Hendricks/WIlliams scale of fat absorption, so the fact that my BMI is 45 and I way 350 pounds, could mean that I am actually healthy"
- "I know someone who had a low BMI, exercised all the time, was apparently healthy - but died of heart troubles (he was shot in the heart during a robbery), so my high BMI and lack of exercise already has me living longer than they did".

I wonder what the correlations are between fat-denialists and global-warming denialists and other denialists.

Literally none of that has to do with my comment.

 

[ohmman]

Suggest this thread be renamed: "Too much BMI talk for TMC?"

 

[TaoJones]

Suggest this thread be renamed: "Too much BMI talk for TMC?"

Better BMI than BMW. The i3 looks like a bloated sneaker. Perhaps a kind i3-owning forum member would indulge idle curiosity and ask BMW what their i3 seat weight and BMI limits are.

I bet that BMW owner wouldn't get responses from the CEO, VP, and regional manager within a day of escalation of anything, let alone seats.

Quibbling over the value or lack thereof of single-source metrics such as BMI aside, this new Sales/Service VP of Elon's seems pretty solid. I was bummed when Jerome moved on (and more power to him and his new project(s)), but the response to this seat thing has been impressive.

 

[S'toon]

Body Mass Index (Dodgy Statistics #22)