@haraldgerhardt Please go back to tumblr.

@colindavies well surmised! I am trying to get different perspectives on the issue. Obesity is more than related to BMI, it is kind of defined by it.
Is obesity and health as intrinsically linked as a lot of people believe, or are we pre-empting an unhealthy diagnosis from attaching a label of obesity on someone?
Is BMI an indicator of a person's health or just their size?

I understand why it's use is so universal, it's fast and easy to do, but it also states that the most important factor in determining if someone is dangerously overweight is how tall their parents were? Can we do better than BMI?

@blairrobson1 , it is not policy in itself, just a first step on a potential part of InternetMANA health policy. To know if the problem exists one must first identify the problem. A lot of people in NZ receive incredible amounts of advice (if they are lucky) and pressure (if they are not) based on a really simple equation. Can we do better than BMI?

This is not a question for a prospective government. BMI is not used because there is some legal standard requiring or even encouraging it.

@hugheldredgrigg It is a common way of measuring. As measurements are required for progress to be defined, the question may not be explicitly about BMI as a policy, but BMI as it relates to measuring the effectiveness of the health policy.

Don't you want the government to be accountable to measurable standards?

Nice loaded question. Do you think that the government should be legislating which forms of measurement people use? I'm not a massive fan of BMI, but legislation is an inappropriate instrument to change the culture that results in its practice.

@hugheldredgrigg " Do you think that the government should be legislating which forms of measurement people use?"

Can you point to where anyone claimed that anyone wanted to legislate what forms any people used? If not, then you are lying by implication. I've seen nothing other than a request for a general discussion on BMI. The only one talking "legislation" here is you (and now me, by pointing your your desire to legislate everything)..

Kia Ora
What deeply concerns me about any discussion about obesity is the implied paternalism - most discussion is always about what we think others should or should not do - it is never about me or what I should do.

By implication, whether well-motivated or not, the target audience mostly appears to be those who are already marginalized.

Obesity is the opposite end of the spectrum to bulimia but I don't see any call to have a policy on skinniness or on image.

As human beings we are a prisoner of our genetics - fat is the most efficient way of storing surplus energy and we are programmed to store energy for future use.

So the key issue here is not a health issue but an issue of energy intake. The reality is that as food production and manufacturing has become more sophisticated and easier we are each able to readily take on more energy than we need. Couple that with less physically demanding work and a more sedentary lifestyle and our energy demand/output decreases an we get the double whammy of increased energy input with decreased demand - add a human biochemistry that has no option but to store that energy and you have obesity.

The key discussion should not be about how we measure obesity but how we encourage people to aware of their energy input and how they can influence that.

Extending the argument further I think that it is simplistic to blame food manufacturers and retailers marketing policies for the obesity pandemic - it is simply about people making choices - it again is paternalistic and smacks of sanctimony and nanny state to suggest that we legislate to solve the problem.

A key philosophical question that I would like to pose is why are we concerned about obesity?

Is it concern as an individual about ourselves and the personal effect on our own health or longevity?

Is it genuine concern for the health and well-being of others?

Or is it a manifestation of our societal concern?

"Can you point to where anyone claimed that anyone wanted to legislate what forms any people used? "

Well, this is a forum to discuss party policy, so I tend to assume that proposals here are proposals for laws that the IP would try to get passed if it successfully becomes part of government.

@peterbarron

A key philosophical question that I would like to pose is why are we concerned about obesity?

First.
I'll stick with the child obesity.
If obesity is a health problem, then it is also a finance problem. So at a glance is it better to treat obesity problems pre puberty, or let them turn into adult health problems that will be far more expensive to treat in the future. Thus early treatment of obesity has many similarities to immunization.

Second. We don't allow other forms of child abuse, but it appears a parent can allow can virtually torture a child by allowing them to expand to a size where there life is deplorable.

it again is paternalistic and smacks of sanctimony and nanny state to suggest that we legislate to solve the problem.

Once again, who said anything about legislation ?
All we have discussing is finding the best measurement system. Policy development does not necessary require legislation development.

@colindavies @peterbarron
Hi Colin, I think what Peter is getting at is a more fundamental question than BMI as a measurement tool. I believe he is saying that if a person believes obesity is a problem they can seek help from their healthcare provider, rather than it being the job of the healthcare provider to say the person is obese. Healthcare from a customer service perspective, giving the customer what they want rather than telling the customer what they need.
To your second point, it is society that causes the child abuse problems of bullying etc, are we by emphasising obesity as a health issue giving tacit approval of that bullying behaviour?

Food for thought anyway!

@andrewlepine The problem with this model is that often "customers" in the healthcare industry are not aware of their health problems until they're well advanced.

@andrewlepine

it is society that causes the child abuse problems of bullying etc, are we by emphasising obesity as a health issue giving tacit approval of that bullying behaviour?

Yes we are, as bullying is a learned behavior IMHO.
We are not only giving said tactic approval but identifying the individuals to be bullied.
However there are easy solutions to this.

back to the original question

Is it actually measuring health in a meaningful way?

Somewhere in the calculation of health, must be cardio-vascular system capability. How large their system is, how good the muscle tissue is, How capable it is of repairing.

is obesity a health problem if the person can run a marathon?
So I finally conclude . No, the BMI usage for measuring obesity is not measuring 'health' in a meaningful way.

The issue should be based on food and exercise. We sould be taxing highly processed food and drinks. We sould tax less, or no tax on whole foods.
Exercise shoul be promoted, even tax benefits, for staying healthy.

BMI and other health measurements if they are correct, and I am yet to belive, as although I acknowledge I need to lose some weight, according to my BMI, I am grossly obese.

If I exercised, my weight will come off quickly, just a bit busy with my PhD.

Any way, eating whole natural food, not prcossed junk will increase the quality of life of our whole population.
Processed food is made by global giants who have done 'studies' to prove they are good for us, such as margarine made from highly processed oil.
The other example is cutting out all processed food using corn syrup. It is in almost every packet of processed food, adds no health content, and it highly impacts the level of non-usable sugar in our body which becomes fat

This is a more important discussion.

@rogenasterling, Don't stress on the grossly obese I'm about 30-31 myself, as obese as Richie MacCaw but not quite so bad as Julian Savea.
My point is that obesity only seems to exist due to BMI, as one defines the other, is there a better method to measure someones health as opposed to their weight?
eg Time to return to resting heart rate from 75% theoretical max (220-age). Suggested to me by PE students at Uni of Otago.

And as to the food and sugar tax etc, that may very well be part of the discussion later, but for any policy directed at obesity we need to confirm if there is a problem there first (measurement) and there is, is it one that it is appropriate to deal with at a legislative level. (individual choice vs public good).

Fun as it would be to put out a press release "InternetMANA will end obesity overnight.... by removing BMI" we want to make sure of our motives on this first.
Politicians questioning their motives? Sounds scary eh!

@hugheldredgrigg "The problem with this model is that often “customers” in the healthcare industry are not aware of their health problems until they’re well advanced."

Are you not making the assumption here that obesity in and of itself is a health problem, take a step back and try to uncouple the term obese from unhealthy. Can you do it? Can you not make the case for individual choice in a matter that is clearly very personal? There is a danger here of government becoming too deeply involved in someones personal choices.

@rogenasterling I will never agree to more taxes on any kind of food. All a junk tax would do is make poor people poorer.

@reidalexanderwicks

All a junk tax would do is make poor people poorer

As sad as it is, that's so true.
All these social engineering ideas on how to make poor people like me healthy and happy, just make the situation worse.
The moment the minimum wage rate is lifted I get ready for my rent to increase.

"Are you not making the assumption here that obesity in and of itself is a health problem, take a step back and try to uncouple the term obese from unhealthy. Can you do it? "

Actually, I wasn't speaking to obesity specifically, I was speaking to Andrew's general idea of a system driven by the customer's own assessment of their needs.

There are quite a few studies out there that prove BMI is a complete load of rubbish. It's a silly piece of math that doesn't take body fat or muscle weight into the equation. Using BMI most body builders would be considered morbidly obese, and someone with a lanky build could be considered under-weight. Throw BMI in the trash where it belongs.

I am personally 'under weight' (read skinny rake!), but it seems to suit my body. Other people are so-called 'obese' and extremely healthy. Let us focus on health instead of weight. We humans come in many colours and sizes. Awesome!

So don't take a blind bit of notice of the so-called 'experts'. That's a copout. At the annual rugby weigh-ins, i was always the heaviest kid for my age when I was skinny as a rake. I put this down to athletic muscle mass. I came 2nd in the Northland 220 yard sprint in a photofinish, and played curtain-raisers for the going bros Northland senior team at Okara park. when I was a winger in the Northland 3rd grade rugby. We thumped Auckland twice. I scored tries in both games. Point being a no stage of my life have I ever been grossly obese, despite the B.M.I. flashing red. I don't trust the bastard and nor should you . . .