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The AMA says BMI is bad way to measure weight and health




The AMA says BMI is bad way to measure weight and health

Body mass index (BMI) is a simple tool for assessing whether an individual falls into a normal weight range for their height. In order to assess your BMI, you take your weight in kilograms and divide it by the square of your height in meters. Those with a BMI of 25 to 29.9 score are considered overweight, while those above 30 fall into the obese category.

However, simple may not mean best. There has been intense scrutiny around using BMI as an indicator of health over the years, with many pushing back on its usefulness, as well as suggesting that overemphasis on BMI may cause more harm than good.

That now includes the American Medical Association (AMA). Here’s what you need to know about BMI.

What’s happening?

On June 14, the AMA announced its recommendation for doctors to no longer use BMI exclusively as a way to assess wellness.

The decision to move away from relying on the controversial height-to-weight ratio stems partially from the fact that the original data collected was based only on previous generations of non-Hispanic white populations.

In the statement, the AMA said that it “recognizes that relative body shape and composition differences across race/ethnic groups, sexes, genders, and age-span is essential to consider when applying BMI as a measure of adiposity and that BMI should not be used as a sole criterion to deny appropriate insurance reimbursement.”

Instead, the AMA suggests that BMI should be used in conjunction with other tools to measure obesity, such as “measurements of visceral fat, body adiposity index, body composition, relative fat mass, waist circumference and genetic/metabolic factors.”

Why there’s debate

On an individual level, BMI has several drawbacks. But it may be a good tool to track rising or falling obesity rates in a population.

One reason why people like BMI is its simplicity. However, it’s the simplicity of this formula that also makes it problematic when assessing individuals. BMI does not account for muscle vs. fat. For example, an athlete may have a low body fat percentage, but a high BMI, due to muscle.

When it comes to health, it also may matter more where you carry fat, which is something BMI can’t tell you. Abdominal fat, for example, has been linked to high blood pressure, Type 2 diabetes and heart disease.

It’s also possible to have a higher than average BMI and be overall healthy, a condition called metabolically benign obesity. This may be due, at least partially, to how different bodies respond to fat. Different racial and ethnic groups may also carry and hold weight differently.

There’s also an important economic reason why BMI should not be the marker of weight and health. Insurance companies may not cover the costs of treatments for people who do not fall into the appropriate category under BMI. For example, in May 2021, the Washington Post reported that a Black woman suffering from an eating disorder was told her BMI was too high for her insurance to cover treatment. She had to pay $800 out of pocket per month.

The tool may also underestimate the number of people who have obesity. A new study presented the annual meeting of the Endocrine Society suggests that BMI misses cases of obesity when obesity is determined by fat vs. muscle percentage.


A better measure than BMI may already exist

A study published on Sept. 20 analyzed 387,000 adult participants from the United Kingdom and found that waist-to-hip ratio (WHR) — the waist circumference measurement divided by the hip circumference measurement, according to the National Institutes of Health — had “the strongest and most consistent association with mortality irrespective of BMI.” The study authors suggested that the clinical recommendations should “consider focusing on adiposity distribution compared with mass.”

Waist-to-hip ratio can assess where more dangerous fat is better than BMI

Dr. Fatima Cody Stanford, an obesity medicine physician, told VeryWell Health that WHR is likely the better indicator of health. “When we carry adipose (body fat) in our midsection, it increases our risk for cardiometabolic diseases like heart disease and type 2 diabetes,” she explained.

BMI is an imperfect tool, but one of the few screening options we have

“Right now, the best tool we have that’s readily available in any clinic is going to be screening based on BMI. We need better things,” obesity medicine doctor Carolynn Francavilla Brown told STAT News. “[The AMA policy] is a push in the right direction, but we also have to accept the reality of what we have right now.”

Focus on BMI can harm the relationship between doctors and patients

“Clinicians’ focus on BMI can lead to unproductive weight-related conversations that fracture the doctor-patient relationship and may introduce mistrust. This can lead to patients opting not to follow physician advice, even when that advice is not weight-focused, and not pursuing follow-up care due to faltering trust, a vital element of effective doctor-patient relationships. Additionally, misplaced BMI assessments can unnecessarily divert clinician focus to weight, an easy default but often misguided explanation for various signs and symptoms, and can result in missed diagnoses, sometimes with grave consequences.” — S. Bryn Austin, professor of social and behavioral sciences at Harvard T.H. Chan School of Public Health, and Dr. Tracy K. Richmond, assistant professor of pediatrics at Harvard Medical School, MedPage Today

BMI may be more accurate than we assume in finding revealing excess body fat

“Despite its limitations and notorious counter-examples, BMI is highly related to body fat and correctly categorizes people as having excess body fat more than 80 percent of the time. Additional simple measurements such as waist circumference may be even more informative because they provide information about where fat is distributed in the body.” — Kevin D. Hall, senior investigator at the National Institute of Diabetes and Digestive and Kidney Diseases, Washington Post

Relative fat mass (RFM) index may be better measurement, without the need for a scale

“The team of researchers behind RFM say it’s more accurate than BMI, and it can also be worked out with just a tape measure — so you don’t need a set of scales to calculate it, as you do with BMI. In the case of RFM, it’s the distance around your waist in relation to your height that counts, rather than your weight. The researchers say that gives a better idea of whether someone’s body fat is at a healthy level or not. ‘We wanted to identify a more reliable, simple and inexpensive method to assess body fat percentage without using sophisticated equipment,’ says lead researcher Orison Woolcott, from the Cedars-Sinai Medical Center in Calif. ‘Our results confirmed the value of our new formula in a large number of subjects. Relative fat mass is a better measure of body fatness than many indices currently used in medicine and science, including the BMI.’” — ScienceAlert

Weight is still something to discuss with your health care provider, even if BMI isn’t used

“The thing I don’t want to happen as a result of this is that people of color and Black people in particular ignore BMI and discussing excess body weight with a health care professional because they misunderstand the intent here. The goal is to personalize how BMI is used in medical decision-making and to move away from blanket generalizations that can lead to stigma and bias.” — Dr. Jamy Ard, professor of epidemiology and prevention at the Wake Forest University School of Medicine, CNN

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Biden warns Netanyahu about the health of Israel’s democracy and urges compromise on court overhaul



Biden warns Netanyahu about the health of Israel's democracy and urges compromise on court overhaul

NEW YORK (AP) — President Joe Biden raised “hard issues,” including protecting the “checks and balances” in a democracy, in a Wednesday meeting with Prime Minister Benjamin Netanyahu, pushing the Israeli leader to find a compromise on a judicial overhaul that has set off months of mass protests in Israel and concerns in Washington.

Biden also raised concerns about the far-right Israeli government’s treatment of the Palestinians, urging Netanyahu to take steps to improve conditions in the West Bank at a time of heightened violence in the occupied territory.

The two leaders sat down and took time to chat one-on-one on the sidelines of the U.N. General Assembly. It was their first meeting since Netanyahu took office at the helm of his country’s far-right government late last year.

Relations have cooled since Netanyahu returned to office with a coalition of ultra-Orthodox and ultranationalist partners. His new government has stepped up construction in West Bank settlements, angering the U.S., and pressed ahead with its contentious judicial overhaul plan despite deep divisions at home and criticism from the U.S. and other allies.

Netanyahu tried to play down concerns about the plan, saying there is “one thing that will never change and that is Israel’s commitment to democracy.”

Biden opened the meeting by stressing the U.S. friendship with Israel as being “ironclad” and saying that “without Israel, there’s not a Jew in the world who is secure. Israel is essential.” But Biden also acknowledged the tensions with Netanyahu’s government and its policies.

“We’re going to discuss some of the hard issues, that is upholding democratic values that lie at the heart of our partnership, including the checks and balances in our systems,” Biden said. He said they would also talk about a path to a negotiated two-state solution with Palestinians and “ensuring that Iran never, never acquires a nuclear weapon.”

A senior Biden administration official said Biden pushed Netanyahu to find a compromise on his planned changes to the Israeli court system. The official, who spoke on condition of anonymity to discuss the private meeting, did not want to characterize Netanyahu’s reaction to what Biden said, only that the Israeli leader understood the need for a compromise.

Israeli media, citing a senior official, said Netanyahu assured Biden he was seeking a compromise. However, Netanyahu has made similar pledges in recent months while pushing ahead with the plan, drawing accusations from his opponents that he is not negotiating in good faith. His coalition pushed the first major piece of the legislation through parliament in July.

A statement by Netanyahu’s office said the meeting with Biden was primarily about brokering a peace agreement between Israel and Saudi Arabia.

The prospect of an agreement was also raised by Saudi Crown Prince Mohammed bin Salman, who said in an interview with Fox News being aired Wednesday that the two countries are getting closer to normalizing relations. But Saudi Arabia’s de facto leader also said it was “very important” to reach a pact on the treatment of Palestinians as part of any agreement.

“We got to see where we go,” he said. “We hope that will reach a place, that it will ease the life of the Palestinians, get Israel as a player in the Middle East.”

The location of Biden and Netanyahu’s long-anticipated meeting — a New York hotel room on the sidelines of the U.N. General Assembly meetings rather than the grandeur of the Oval Office — has been widely interpreted in Israel as a sign of U.S. displeasure with Netanyahu’s new government.

Netanyahu has been a frequent White House visitor over the years, and Israeli leaders are typically invited within weeks of starting their tenure to the Oval Office. But his judicial proposals have raised concerns within Israel as well as the U.S. about his commitment to a democratic system.

Bien held out the possibility of the coveted Oval Office meeting, saying, “I hope we’ll see each other in Washington by the end of the year.” The U.S. later formally invited Netanyahu to the White House, eyeing a meeting in November or December.

Biden himself has repeatedly raised concerns about Netanyahu’s plan to overhaul Israel’s judicial system.

Netanyahu says the country’s unelected judges wield too much power over government decision-making. His plan seeks to give more authority to the ruling coalition in parliament, which he heads. Critics say that by weakening the independent judiciary, Netanyahu is pushing Israel toward authoritarian rule.

The plan has divided the nation and led to months of mass protests against his government. Those demonstrations followed him to the United States, with large numbers of Israeli expatriates waving the country’s flag in protest Wednesday in New York. Hundreds of Israelis also protested outside the U.S. Embassy in Tel Aviv on Wednesday.

Early this year, Biden voiced his unhappiness over the judicial overhaul, saying Netanyahu “cannot continue down this road” and urging the Israeli leader to find a compromise.

The Israeli government’s treatment of the Palestinians has also drawn American ire. Netanyahu’s coalition is dominated by far-right ultranationalists who have greatly expanded Israeli settlement construction on occupied lands claimed by the Palestinians for a future state. Israel’s government also opposes a two-state solution between Israel and the Palestinians — a cornerstone of White House policy in the region. The deadlock has coincided with a spike in fighting in the West Bank.

According to a White House summary of the talks, Biden stressed the “need to take immediate measures to improve the security and economic situation” in the West Bank, where violence between Israelis and Palestinians over the past 18 months has intensified to its worst levels in roughly two decades. The two leaders also reaffirmed their intention to stop Iran from acquiring nuclear weapons.

The Biden-Netanyahu meeting came at a time of cooling ties between Israel and the Democratic Party. A poll by The Associated Press-NORC Center for Public Affairs Research found that while Americans generally view Israel as a partner or ally, many are questioning whether Netanyahu’s government shares American values. Republicans were significantly more likely than Democrats to call Israel an ally with shared values.

Topping Netanyahu’s wish list were discussions on U.S. efforts to broker a deal establishing full diplomatic relations between Israel and Saudi Arabia. The White House statement said Biden and Netanyahu discussed the shipping and rail corridor announced at the Group of 20 summit that would connect Israel with Saudi Arabia, the United Arab Emirates and Jordan.

Netanyahu, who also led Israel when President Donald Trump brokered the “Abraham Accords” between Israel and four Arab countries, said a similar deal with Saudi Arabia would “go a long way” to promoting Israel’s relations with the broader Arab and Muslim world and help advance “a genuine peace” with the Palestinians.

The White House has acknowledged that it is seeking such a deal, but obstacles lie in the way. Saudi Arabia is pushing for a nuclear cooperation deal and defense guarantees from the U.S.

The Saudis have also said they expect Israel to make significant concessions to the Palestinians.

The Saudi foreign minister, Prince Faisal bin Farhan, told reporters “there is no other way” to solve the conflict than by establishing a Palestinian state. But senior ministers in Netanyahu’s government have already ruled out any concessions to the Palestinians.


Federman reported from Jerusalem. Associated Press writer Isabel Debre in Jerusalem and AP Diplomatic Writer Matthew Lee in Washington contributed to this report.

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A ‘sugar baby’ is taking over TikTok with her post about the many demands her ‘daddy’ has for her, but the real story is wilder than you’d think



A 'sugar baby' is taking over TikTok with her post about the many demands her 'daddy' has for her, but the real story is wilder than you'd think
  • A TikTok influencer shared how they got ready for their “sugar daddy.”

  • Then came the twist: The “sugar daddy” in question was the US Army.

  • “Did I say sugar baby? I meant soldier,” user Desirè Victoria said on TikTok.

Stay fit. Look good. And, in return, get that bag. These are the hallmarks of a sugar daddy arrangement.

But a TikToker going viral for sharing the strict requirements that they follow for their “sugar daddy” revealed that the man wasn’t a rich businessman paying for their lifestyle: It was Uncle Sam.

“Did I say Sugar baby? I meant Soldier,” Desirè Victoria wrote in a TikTok post published on August 27.

Victoria’s video, which has 4.5 million views and over half a million likes at press time, starts off with them getting ready for the “sugar daddy.”

“He definitely prefers my hair ponytail pulled back away from my face when it comes to my appearance as a whole,” Victoria said. “He likes it very natural. He’s a wholesome man. When it comes to, like, my actual body, he likes fit and healthy.”

Victoria said the “sugar baby” benefits include money for rent, flights and transportation, and personal expenses.

The monologue ends with a twist, however, with Victoria suiting up in an Army uniform.

Many people flooded the comments saying that Victoria’s video had them fooled.

“This was great! The US Army needs to use this as their recruiting commercial, I was sold!” one commenter wrote under the video.

Some said they could see the twist coming based on the T-shirt Victoria was wearing in the video.

“When I saw the green shirt, I said oh she talking bout Uncle Sam,” read one comment.

The popularity of the video follows a trend of military influencers going viral on TikTok for sharing glimpses of their life with the armed forces.

Better known as Military TikTok, or “MilTok,” videos under the genre usually offer humorous takes on their life in uniform.

Last month, a US Army soldier named Anthony Gonzales went viral for his videos poking fun at Gen Z and how they might react on the battlefield.

Gonzales told the New York Post in a story published in July, that he was going to become an influencer after his Army contract ends in two years.

The US Army had earlier banned soldiers from using TikTok on government devices, according to a report by in December 2019. The ban does not apply to the troops’ personal devices.

“We cannot direct anyone to do anything with their personal devices. If they do download this or any application on their device they are recommended to be wary of the ones they download,” US Army representative Robin Ochoa told Insider in a story published in January 2020.

According to a US Army webpage on personal social media use, personnel are told to “avoid use of DoD titles, insignia, uniforms or symbols in a way that could imply DoD sanction or endorsement of content on your personal page.”

Gonzales’ TikTok account currently does not contain any videos as of press time.

It is unclear if Victoria’s video is a violation of the US Army’s standards for online conduct.

Representatives for Victoria and the US Department of Defense did not immediately respond to a request for comment from Insider sent outside regular business hours.

Read the original article on Business Insider

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Some Virginia Democrats say livestreamed sex acts a distraction from election’s real stakes



Some Virginia Democrats say livestreamed sex acts a distraction from election's real stakes

RICHMOND, Va. (AP) — More Virginia Democrats on Tuesday cast the controversy surrounding a legislative candidate who livestreamed herself performing sex acts as a distraction from the stakes in this fall’s elections, while stopping short of fully championing her continued campaign.

Neither the state party nor the House Democratic caucus has publicly called for Susanna Gibson to end her campaign after it was revealed last week that she had sex with her husband in live videos posted on a pornographic website and asked viewers to pay them money in return for carrying out specific sex acts.

But neither group has publicly declared how much support — financial or otherwise — Gibson can expect moving forward.

“Our focus is and has always been on flipping the House and taking back the majority. The MAGA Republicans are continuing to try to distract us while working to implement their plan to ban abortion and roll back the rights and freedoms of all Virginians,” House Democratic Caucus Executive Director Amy Friedman said in a statement to The Associated Press.

House Democratic Leader Don Scott said in a brief interview Tuesday: “Us regaining the majority is all I’m focused on so that we can make sure we protect women’s reproductive freedom.”

Del. Dan Helmer, campaign chair for the House Democrats, said Monday his thoughts were with Gibson’s family while emphasizing that she’s running against an opponent who supports additional restrictions on abortion.

Every seat in the General Assembly, which is currently politically divided with the House of Delegates controlled by Republicans and the Senate by Democrats, will be on the November ballot. Both parties see a possible path to total control, and the suburban Richmond seat where Gibson, a nurse practitioner, is competing with retired home builder David Owen is seen as a critical battleground.

Virginia Democrats, Gibson among them, have made protecting abortion access a top campaign priority. Many Republican candidates in competitive districts, including Owen, have coalesced around GOP Gov. Glenn Youngkin’s proposed ban on abortion after 15 weeks with certain exceptions. Most abortions take place before that cutoff, federal data show.

Virginia, an outlier in the South for its relatively permissive access, currently allows abortion during the first and second trimesters. The procedure may be performed during the third trimester only if multiple physicians certify that continuing the pregnancy is likely to “substantially and irremediably” impair the mental or physical health of the woman or result in her death.

Gibson’s campaign did not respond to an interview request or a detailed list of questions from the AP on Tuesday. Gibson previously denounced the release of the videos as a violation of law and her privacy. She’s given no indication of ending her campaign, saying she won’t be intimidated or silenced.

On Tuesday, the Richmond Times-Dispatch published a commentary piece by Gibson addressing prescription drug prices and her work in health care. She didn’t mention the controversy.

While the caucus and some of its leaders have weighed in, many other Virginia Democrats have either declined to comment, insisted on anonymity to discuss their frustrations or deliberations about the matter, or have not responded to media inquiries. The state party also maintained its silence on Tuesday, with spokesperson Liam Watson declining to comment.

Among elected officials, Democratic state Sen. Louise Lucas has stood out for her early, clear and vocal support of Gibson.

A spokesman for U.S. Rep. Abigail Spanberger, who previously endorsed Gibson, did not immediately respond to an emailed inquiry asking about a post on X, the social media platform previously known as Twitter, featuring Spanberger and Gibson that appeared to have been deleted.

Clean Virginia, an energy policy advocacy group that’s a major donor to mostly Democratic candidates, is “not commenting on this story,” spokesperson Cassady Craighill said. Clean Virginia gave Gibson $175,000 in August, according to campaign finance records, which also show Gibson ended the latest reporting period with over $460,000 cash on hand, about $220,000 more than Owen.

Citing what he called Gibson’s “remarkable” fundraising, Bob Holsworth, a longtime political analyst, said he thinks it’s entirely possible that Democrats “come back in the end” and help Gibson campaign and raise money.

“My big question is: Does she still have the organizational volunteers who are going to generate enthusiasm and turnout?” Holsworth said.

Most Republican elected officials also have kept their distance from the matter, although the state party has spoken out, casting Gibson’s behavior as disqualifying.

In a social media post days after the news broke, the Republican Party of Virginia accused Democrats of “celebrating a candidate who moonlights as a porn star,” adding: “They are the party of moral decay.”

Aaron Evans, a campaign spokesperson for Owen, said Tuesday that Gibson’s campaign was misrepresenting Owen’s position on abortion.

“The Gibson campaign is dumping thousands of dollars into lying about David’s commitment to defend choice during the first 15 weeks of pregnancy and his support for exceptions in the cases of rape, incest, and health of the mother. The fact they are lying about David reinforces that his common-sense, consensus building position is resonating with voters for a win in November,” Evans said in a written statement.


Associated Press reporter Denise Lavoie in Glen Allen, Virginia, contributed to this report.

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