Body Fat; What is it? How much do I have? Can it be calculated? And the BMI Dog and Pony Show.

Now that obesity is an official disease (as determined by the AMA), what defines obesity? I personally use a mirror, a camera, a tape measure, skin fold calipers, impedance scales and course, my trusted Key Performance Indicators (KPI’s). However, medical professionals will pick BMI. My ‘Pill Pushin’ doctor does and he has constantly reminded me that I am overweight based on BMI.

Despite the fact he can see and has routinely commented on my general good shape (I have carried 20% or less body fat over the last 10 years) and exceeding the ARMY’s standard, he still includes BMI and the term ‘overweight’ on my checkup records. Generally, I run between 18 and 20% and more recently (here in Taiwan), I have been at or just below that 15% mark. And even at 15% body fat, I am still overweight based on BMI. Yep, at 5’9” and 178 lbs, I’m considered overweight. The ARMY says I can weigh up to 186 lbs before we have to start measuring necks and waists to determine fitness for duty. So gosh, at 190 I must be a real blimp. Just to get my BMI into the normal range for my height, I would have to drop below 168 lbs whereas a healthy Body Fat ratio for a guy my age is 18 to 24%. So what do you think; 178 lbs and 14 to 18% body fat, am I overweight?

Standard BMI Index

Condition	BMI Range
Severely Underweight	< 16
Underweight	16 to 18.5
Normal (Healthy Weight)	18.5 to 25
Overweight	25 to 30
Obese	> 30

Body Fat Ratio Index

Condition	% Body Fat Range Men	% Body Fat Range Women
Essential Fat	3 to 5%	10 to 13%
Athlete	6 to 13%	14 to 20%
Fitness	14 to 17%	21 to 24%
Average	18 to 24%	25 to 31%
Obese	24% +	32% +

And how do I know what my exact Body Fat percentage is? I really can’t give you an exact measure but I can come close. Read on and hopefully after you review the various methods presented, you will find a best combination of methods that fits your needs.

When I started down this path, losing weight to find normal, to look normal and to fend off perpetual medication, I did make it to 165. And at 165 my blood work was normal, no blood sugar issues or cholesterol issues. However, it was short lived. I actually looked and felt like crap; skinny, drained, tired and always hungry. I can tell you from experience, just losing weight is NOT the answer, it is not normal. It just wasn’t worth feeling like crap all of the time; there is a quality of life issue here. However, I didn’t give up; I stuck with my original training plan, cut back on the cardio and ate a bit more freely of what I wanted to eat. So slowly, over the course of a year, I gained 25 lbs. And, at 190 with body fat hovering in around 20% (maybe a bit higher), even though I looked normal and felt tremendous, my blood work was out of whack again; high cholesterol unbalanced HDL and LDL plus fasted glucose jumping closer to 120 mg/dl than not. And as a side note, the year that I gained that 25 lbs is the year I started making heavier lifts, adding more weight to the bar and became more curious as to the effects of food and exercise on appearance and health.

So if you have followed this Blog over the last 4 years, then you have followed my journey back, gaining on that Last 10 Pounds.

Yes folks the fight is;

• How do you gain muscle mass and keep it, especially in middle age,
• eat just about anything you like, when you like, and
• simultaneously, keep the Fat off.

So during the battle to look and feel NORMAL, what you will discover; low muscle mass and excess Fat that are the issue. As I’ve said before, diet alone is not the fix; exercise that adds muscle must be included in the cure. Just losing weight will leave you weak and in some cases, debilitated.  And how can I make such a bold statement?

Because as you will discover when you make the same journey; it’s the Fat, NOT the weight that is the DISEASE. It’s the percentage (%) of Fat I’m carrying, not my total weight that causes me to look fat and screws up my metabolism. And I bet if you were to track yours (% fat vs. health, % fat vs. appearance, % fat vs. fitness), you’ll find the same answers.

Now don’t get me wrong, diet will account for 80% of your overall ‘Get To Normal’ strategy, although without that 20% muscle building component (exercise), you will most likely never see the health and fitness gains that go along with reducing body fat.

So if it’s the Fat that is the disease, why does the medical establishment look at weight as the basis for the disease? Is it some sort of triage or prioritizing process, a need to categorize groups for some statistical reason? Personally, I pay my ‘Pill Pusher’ for my visits, so my expectation is that while I’m in his office, I am the priority and my condition (diagnoses) based on reason, logic and common sense is what I’m after, not to be statistically classified.

However, if I were a pharmaceutical manufacturer or insurance company and had lobbied to categorized people by some ambiguous metric, weight for instance, to determine disease, then statistically I could make a lot more sales or jack up my rates based on higher risk. And sales relate to Profits. First and foremost, it’s easy to categorize this metric, step on the scale, measure you height and bingo, you’re either fit or fat. There is no assessment or diagnoses, just the fact than you don’t fit within a statistical category. You could be a power lifter or body builder or sprinter or linebacker or even meet the ARMY’s height to weight criteria, however based on BMI, you are statistically Fat and therefor you are diseased. Realistically you are statistically a Potential New Customer for the latest in weight related pharmaceuticals and a target for increase insurance rates.

And did you also realize that the BMI scale in use today was developed well over 150 years ago, somewhere in the mid 1800’s. Isn’t it time that we modernized the scale, maybe looked at other measurable metrics that are better indicators of health. Maybe develop a set of meaningful KPI’s. Hasn’t medicine advance in the last century? Why are we using the archaic to judge a modern condition? 

So the next time you go to the doctor for a checkup and he jots down your BMI, and the notation overweight or obese, and you know deep down, based on dieting, exercise and just plain Hard Work to lose the Fat, to look NORMAL, you need to challenge that sucker. Make him look you in the eye and say you are overweight. Make him diagnose your condition. If obesity is classified as a disease, then you need to be diagnosed, not just categorized against some statistic.

So WHAT makes it so difficult to measure Body Fat? WHY has the establishment gone BMI when they know it’s a Fat issue, not a weight issue?

So let’s review a couple of my favorite Fat Measuring Methods and the Pro’s and Con’s associated with each. Maybe we can use some ‘blue collar logic’ to see if there is a better method of diagnosing obesity.

• As quoted by many health and fitness professionals, the gold standard, believe it or not, is Autopsy. Yep, they dissect you, put all the fat in a bucket and weigh it. Very accurate, however, very impractical; you would have to be dead to get a good measurement.

• Dual Energy X-Ray Absorptiometry (DXA) is the next best approach. It uses a special X-Ray device that was originally designed for bone density assessment; as in Osteoporosis diagnostic, etc… Scanning for body fat is a secondary application. And depending on the technician and doctor reading the film, it may not provide any better of an indication than a mirror and your own assessment. The really cool part though, it will tell you exactly where the fat is. This may allow different diet or training strategies. Although, I think the radiation exposure for a weekly assessment, not to mention the cost, would be intolerable for most.

• Bio-impedance is another cool technology that just doesn’t quite work as advertised. Basically you have a device that passes a high frequency, low voltage AC current through your body and based your total water content and some guesswork (math freaks call it an algorithm), gives you a simple Body Fat percentage. The ideal is that muscle is 70% water and is more conductive than Fat. At issue is your level of hydration; generally hydration is inconsistent throughout the day, effected by things like exercise, sleep, stress and ambient temperature or even relative humidity. Secondly, the algorithm used is different depending on the actual amount of muscle mass you carry. For an athletic individual, the Body Fat calculation would be different than if we were calculating the Body Fat of a couch potato. Same for Boys and Girls, different algorithm. However, these devices are widely available, inexpensive and can be purchased from Wal-Mart, Target, etc… So if you did a once a week weigh in, say just before you jump in the shower on Sunday morning, it should be consistent enough to show you a delta from week to week. Although, don’t be surprised that once you reach a certain level, it becomes inconsistent or even erratic.

• Displaced water weight is the difference between your dry weigh and your submerged weight and in theory would be very accurate. However, try to find a scale. Plus most people would see this as pretty inconvenient for a weekly weigh in. As a variation of this method, I once read an article that had you hold various weights wile floating with your knees tucked under your chin (canon ball style). If you sank, you were holding too much weight and if your back came out of the water you were holding too little. If you held a weight equal to your Body Fat weight you would float right at the surface. Keep in mind, that to get a good representation, you need to blow all of the air from you lungs and then hold your breath. A pretty cool science project but sort of impractical.

• The ARMY Standard that I posted in the original Blog, A Book is Judged…is still my favorite choice. However, I have come to realize that the height to weight charts are based on a ‘mesomorph’ body profile. And at the maximum height per weight per age group table, you are pushing the upper limit of a healthy Body Fat percentage; approximately 22% for men and approximately 32% for women. So if your profile leans toward ectomorph (tall and thin) or endomorph (short and stocky) then accuracy falls off sharply, especially as you approach and drop below 20% (30% for women) Body Fat. Although, if you are up to 100 lbs overweight (excuse me, over-fat) and just starting this journey, I highly recommend this method, it’s cheap, it’s easy and it can be used to track progress and get you to normal…and in my opinion, is more consistent than the bio-impedance scales and skin folds and a heck of a lot more convenient then X-Ray, water weighing and of course, autopsy. In fact it is almost as convenient as determining BMI.

• For men only and for those under the 20% mark and looking to make a visual statement on your health and fitness; then a tape measure and a simple bathroom scale can be used to compare yourself to what the original Mr. Fitness, Steve Reeves, (champion body builder from the 50’s and 60’s) thought were the Golden Measurements of proportion and symmetry. I personally think he borrowed these proportions from Michelangelo. Anyway, no matter where they came from, if you can actually attain these proportions (no drugs allowed), my hat is off to you. And if you can hit these numbers when you’re over 50, you are my hero. Ladies, I’m sorry, there may be something similar out there for women, I just haven’t bumped into it as of yet.

Height To Weight
5’6”	5’7”	5’8”	5’9”	5’10”	5’11”	6’	6’1”	6’2”	6’3”
165	170	175	180	185	190	200	210	220	230

        

Body Part Proportions
Wrist	Measure (smallest circumference)
Ankle	Measure (smallest circumference)
Knee	Measure (largest circumference)
Head	Measure (largest circumference)
Hips	Measure (largest protrusion)
Bicep	252% of Wrist
Chest	148% of Hips
Neck	79% of Head
Waist	86% of Hips
Thigh	175% of Knee
Calf	192% Ankle

The basic procedure for this comparison is to measure your wrist, ankle, head, hips and knee circumferences, do the math and based on the height to weight table above, see where you fall. If you can get within 3% of the calculated values, then you should probably be modeling underwear; you are a god.  

• Another inexpensive device that is commonly used is a cheap pair of skin fold calipers. There are numerous sites that pretty much give these away. And, in front of a mirror, by yourself, you can generally collect at least 3 data points; thigh, abdominal and pectoral. There are dozens of web sites where you can plug in your measured skin folds and come up with an estimate of body fat. Keep in mind that this estimate is again based on a statistical representation that is different for male and female and different age groups. And again, skin fold dimensions very based on hydration, exercise and how hard you squeeze the pinchers. What I have found is that if you are over 50 and below 20% Body Fat, the measured percentage is way lower than actual. However, like bio-impedance, if you were to pick a certain set of conditions (like 1^st thing Sunday morning) they should give you an indication of change from week to week.

Now the cheapest of the cheap skin fold devices is your thumb and index finger. In the book, Natural Bodybuilding Bible, by Tyler English (sold through the on line magazine, Men’s Health) Tyler comes up with the ultimate of estimates. Pinch the skin on your thigh and measure the skin fold at its thickest cross section; ½” = 12%, ¾” = 15% and 1’ = 20%.

• Another inexpensive method is a camera and a comparison against known levels of Body Fat. This is harder than you think. If you scan the internet looking for a simple picture of a specific body fat level, they are pretty few and far between. Quite a few sites include some sort of computer generated 2 dimensional paper doll that are really quite poor as far as visuals. And if you search long enough you’ll eventually bump into Leigh Peele’s web site. She has a PDF booklet that looks at the same items I have covered above (scans, meters, calipers) plus she attempts to give you a visual representation of what each Body Fat level looks like. It’s a pretty low resolution representation. She also makes the offer that if you join her site, send her a photo, she’ll use her educate eye to give you a best guess. Mrs. Peele’s web site is;

http://www.leighpeele.com/

One other visual comparison I ran into, from the on-line magazine This Is Why You Are Jacked, defines Body Fat ratio’s through simple ‘slang’ that I truly found entertaining. 

Full House – 20% Body fat and beyond

Hard – around 15%

Cut – 12%

Defined – 10%

Ripped – 7 to 9%

Shredded - 4 to 7%

Diced – 3%

Although these visuals really don’t help much if you are just starting out on a Fat loss journey, for fun you should take a peek;

http://thisiswhyyourejacked.com/a-body-fat-percent-picture-guide/

As can be seen, there certainly isn’t a lack of strategies or methods that could be used to measure Body Fat; some are realistic and some are not.

And looking at all of the various options that could be used to measure Body Fat (instead of BMI) in diagnosing the disease of obesity, it looks like the ARMY standard would be just as easy to implement as the existing practice and even more appropriate, just need to add a tape measure to the list of needed tools and measure neck and waist (and hips if you’re a girl) circumferences along with height and weight. The standard could also be tweaked a bit to better fit ectomorph and endomorph body profiles. However, it’s still a pretty good standard and is a heck of a lot more representative of the disease than BMI.

So why didn’t the medical establishment select the same process that our modern ARMY uses to determine whether you have a Fat related disease instead of a metric that doesn’t specifically account for fat (the What and Why of BMI)? I hate to be a cynic, but I bet big pharmaceutical and medical insurance lobbyists are at the top of the list in influencing that AMA decision.

Just think, I can meet the ARMY’s standard and be considered fit enough to defend a nation yet be labeled as Fat and have to pay higher insurance premiums so that I can afford the big pharma’s new medications that keep me from getting even heavier.

So again, don’t let your doctor push you around. If he or she starts talking BMI and thinks your weight is the issue, you need to correct him, you need to challenge him, you need to tell him Fat is the issue and that your Body Fat ratio is normal or tell him the things you are doing to get your Body Fat ratio in line with normal. Tell him that BMI is the wrong metric and you don’t want to hear BMI. If you’re fat, make him diagnose you as over-fat using an appropriate metric. Once diagnosed, have him help you develop a plan to work on fat lose, not just medicate you based on symptoms. If he can’t or won’t, maybe you need to find a new doctor!

And if you work hard and stay dedicated to good nutrition and exercise (hit the weights specifically) you will gain on That Last 10 Pounds (of Fat).