BMI is a widely used measure of body fat and is used to determine overweight and underweight. However, BMI is often criticised because it is not meaningful when certain physical characteristics are present. This is also the case with lipedema.
BMI does not take into account age, gender or specific physical characteristics. As a result, it is not very meaningful for people with different physiological characteristics.
BMI does not differentiate between muscle and fat mass, which can lead to distortions, especially in people who are athletic or have a muscular build.
Another criticism is that BMI does not take into account the distribution of body fat. This is particularly important in the case of lipedema, a condition in which fat accumulates disproportionately on the legs and arms. Due to the increased adipose tissue in people with lipedema, the legs and arms are often out of proportion to the trunk. The BMI therefore automatically assumes that most patients are overweight. Even if there is extra weight, the BMI will be much higher because of the lipedema.
Currently, BMI is incorrectly used as an indicator for liposuction. Liposuction for lipedema can be covered by health insurance from stage III and below a BMI of 35. However, it is not possible for every lipedema patient to lose weight to a normal weight.
A much more meaningful measure, especially for lipedema patients, is the waist-to-hip ratio. This is the waist circumference (in centimeters) divided by the hip circumference (in centimeters). In people with lipedema, the hip circumference is at least 1.4 times larger than the waist circumference.
The waist-height ratio is calculated as waist measurement divided by height measurement. This approach enables a more differentiated assessment of body shape and composition compared to the BMI.
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