Department of Medicine, Division of Endocrinology, David Grant Medical Center, Fairfield, CA 94533, USA.
Department of Medicine, Division of Endocrinology, Hunter Holmes McGuire VAMC and Virginia Commonwealth University, Richmond, VA 23249, USA.
Mil Med. 2022 Jul 1;187(7-8):201-203. doi: 10.1093/milmed/usab447.
Many active duty service members and their health care providers feel that the current body mass index (BMI) standard for diagnosing obesity, BMI ≥30 kg/m2, may unfairly overclassify as obese those with higher muscle mass. Unfortunately, a closer look at the data available for service members repeatedly demonstrates the exact opposite: we are actually underestimating the rates of obesity in service members using current BMI cutoffs when compared with body fat mass as measured by either dual-energy X-ray absorptiometry or bioelectrical impedance analysis as the gold standard. Using a lower BMI threshold and refining positive results via history, exam, labs, and/or more specific measurements of body composition would more accurately estimate body fat percentage in active duty service members while remaining convenient and scalable. Given the current obesity epidemic in our nation, this suggests the critical need for new approaches to screening, as well as treatment, of overweight and obesity in our military to improve service readiness.
许多现役军人及其医疗保健提供者认为，目前用于诊断肥胖的身体质量指数（BMI）标准（BMI≥30kg/m2）可能不公平地将肌肉质量较高的人过度归类为肥胖。不幸的是，对现役军人相关数据的进一步研究反复表明，事实恰恰相反：与双能 X 射线吸收法或生物电阻抗分析等金标准测量的体脂肪量相比，目前使用 BMI 截止值来诊断肥胖的现役军人肥胖率实际上被低估了。使用较低的 BMI 阈值，并通过病史、体检、实验室检查和/或更具体的身体成分测量来细化阳性结果，将更准确地估计现役军人的体脂肪百分比，同时保持方便和可扩展。鉴于目前我国肥胖症的流行，这表明迫切需要新的方法来筛查和治疗超重和肥胖，以提高军队的战备能力。
