Gauging Body Mass Index in a Changing Body

By GINA KOLATA
Published: June 28, 2005

Consider this example: A woman's weight has not changed over the years
but osteoporosis has robbed her of inches in height.

Because of her compressed spine, she is thick around the middle and her
abdomen protrudes. But her arms are thin.

Is she fat? Should she lose weight? Which height should she use in
deciding her ideal weight - her original height or her new one?

[SNIP]

On one side are experts like Dr. Claude Bouchard, an obesity researcher
who directs the Pennington Biomedical Research Center in Baton Rouge, La.

"My first reaction is you use your current height," he said.

But, he added, in the elderly, if health is the concern, older people
should not be too worried about their weight. *Among older people, he
said, "The impact of excess weight on mortality and morbidity is not
very strong."*

In the other camp is Dr. Jules Hirsch, an obesity researcher at
Rockefeller University. Hearing that other experts had concluded that
the woman should use her current height, he said, "They are wrong."

"She has an orthopedic peculiarity," Dr. Hirsch said, and even though
the woman's spine is compressed or hunched, "her fat mass is exactly the
same."

*"Probably what the poor soul needs is as much fat as she can get," he
said.*

Aromatase, an enzyme in fat, can produce estrogen from androgens. And
since estrogen helps prevent bone loss, the woman should try to keep her
fat, Dr. Hirsch said. She should be "making every tad of estrogen she
can make," he added.

The whole article can be found at:
<http://www.nytimes.com/2005/06/28/health/28bmi.html?oref=login>