AMA changes BMI to BF%, hip:waist, genetic factor
The American Medical Association has made a major policy change in assessing obesity.
In addition to body mass index (BMI), there are now three additional factors to consider: body composition, waist-to-hip ratio, and genetics. Because insurance coverage for obesity treatment has historically recognized only BMI, this policy change (from the largest association of physicians in the country) is an important step in moving the American medical establishment towards better health for all.
BMI has been used in population studies of weight and health for decades because of its simplicity and ease of accurate data collection. However, by using only height and weight, BMI is completely blind to other measurements that are equally or more important, such as width/depth of your frame and your body fat percentage. Why body fat? We used to think body fat was fairly inert, but we now know it is a very biologically active tissue, influencing everything from appetite to how well we utilize insulin. In fact, adipose (fat) tissue is now considered an endocrine organ like the pancreas and reproductive system!
In addition, many of the studies that established the categories for BMI risk (<18.5 is underweight, 18.5-24.9 is normal weight, 25-30 is overweight, >30 is obese) were based only on non-hispanic white populations. More comprehensive data has shown that this bias in BMI can gloss over health risks related to fat’s distribution in the body that are more prevalent at lower BMI scores in populations of Asian, Hispanic, and Black people.
Baskin Clinic offers patients free body composition testing at the office using an InBody machine. Contact us on Spruce if you’d like to learn more about the test and schedule a visit.
Obesity drugs in the news
Speaking of weight loss, if you’ve been online or even near the news over the past several months, you’ve likely been bombarded with information about a class of drugs called GLP-1 agonists. These were originally created to treat diabetes, but the real bonanza is that the newest generation (think Ozempic) has been found to produce significant weight loss. There are several of these drugs, and they’re all slightly different, but they’re similar in that they mimic a hormone in the body that results in increased insulin sensitivity and decreased appetite. There is some evidence that they might help reduce compulsions beyond eating.
Ozempic (semaglutide) was approved as a diabetes medication a few years ago. More recently, semaglutide was rebranded as the weight loss drug Wegovy. A number of similar drugs have been approved or are in the pipeline towards approval, some with even greater effects on weight loss than Wegovy. However, it’s important to know that we do not have good evidence regarding their long-term benefits and disadvantages. One thing we do know: these drugs’ effectiveness last only as long as they are being taken. And at a cost of around $1,000 month, that could be a hard pill to swallow, especially since insurance coverage has been very halting.
Will these drugs replace bariatric surgery? The jury is still out. For now, bariatric surgery is still the gold standard in terms of cost, effectiveness, and long-term outcomes. But there may be people for whom a medication option will be more appealing. And we’re excited to see more tools in the toolbox for treating this chronic disease.
Speaking of weight loss, if you’ve been online or near the news the past several months, you’ve likely been bombarded with information about a class of drugs called GLP-1 agonists. These were originally created to treat diabetes, but the real bonanza is that the newest generation (think Ozempic) has been found to produce significant weight loss. There are several of these drugs, and they’re all slightly different. But they are similar in that they mimic a hormone in the body that results in increased insulin sensitivity and decreased appetite. There is some evidence that they might help reduce compulsions beyond eating as well.
Ozempic (semaglutide) was approved as a diabetes medication a few years ago. More recently, semaglutide was rebranded as the weight loss drug Wegovy. A number of similar drugs have been approved or are in the pipeline towards approval, some with even greater effects on weight loss than Wegovy. However, it’s important to know that we do not have good evidence regarding their long-term benefits and disadvantages. One thing we do know: these drugs’ effectiveness last only as long as they are being taken. And at a cost of around $1,000 month, that could be a hard pill to swallow, especially since insurance coverage has been very halting.
Will these drugs replace bariatric surgery? The jury is still out. For now, bariatric surgery is still the gold standard in terms of cost, effectiveness, and long-term outcomes. But there may be people for whom a medication option will be more appealing. And we’re excited to see more tools in the toolbox for treating this chronic disease.
Don’t get overcharged for generic medications
By law, Oregon pharmacies are always supposed to substitute generics when available, unless a prescription specifies brand name only. However, we’ve been hearing reports that many pharmacies are selling erectile dysfunction medications like sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) at the branded price… and it appears to be happening more frequently. You should never pay more than about $0.30/pill for these (or $10-20 for a prescription). Your insurance should cover much of the cost, but if it does decline, get a coupon from goodrx. We are also happy to help you with this process.
We always try to leave you with a little treat as a thank you for reading.
It’s about to get hot this weekend, so what more appropriate time to check out Hot Ones, the celebrity interview show that features hot wings and even hotter questions. Don’t you just love Melissa McCarthy? 🙂
Take care,
Baskin Clinic