I’m too fatigued right now to pull up my prior posts on the subject with compelling references but the linked article links survey research that says the same t

I’m too fatigued right now to pull up my prior posts on the subject with compelling references but the linked article links survey research that says the same thing. BMI alone is a poor measure but when coupled with physical fitness and activity metabolically healthy overweight and obese type 1 tend to have similar health outcomes to physically fit and active normal BMI. The key is physical activity and fitness are key to health, and likely at some physical threshold aggregate size of body drags it down no matter what (inclusive of athletes with huge frames). BMI is a quicker to compute metric than metabolic and cardiovascular health, easier to measure in a doctors office than factoring reported physical activity, and therefore is probably a decent medical tool for providing advice. But the advice is going to be eat healthy and exercise no matter what the BMI is. So maybe BMI isn’t specifically useful, so maybe instead of telling an overweight person they’re fat (they probably knew) and therefore should exercise and eat healthy, likewise telling everyone else the same advice, just skip the “you’re fat” and give everyone the same advice as already happens. I don’t think anyone is surprised by “get fit eat right” is good medical advice. Edit: as to why, I know a lot of obese folks that avoid their doctors because they feel harangued about being over weight. They know they’re fat and they’ve likely been working on it for some time, and the “you’re fat” + axiomatic health advice isn’t helping them vs simply axiomatic health advice. Psychologically it’s shaming, and shame is a powerful force in human psychology. Whether “you’re fat” is reducing their long term health or not is irrelevant since the advice is the same regardless, and it drives them away from their doctors from their shame. That’s not useful, and I’d hope utility is more important than reinforcing axiomatic medical advice with shaming. I know everyone will say “who cares if they’re ashamed it’s a fact,” but who cares in this is their doctor and the patient. That should have primacy over all.