CONNECT: March 2012

Does BMI Matter?

Interview with Dr. Damian Rigatti, D.O.

We caught up with local physician, Dr. Damian Rigatti, D.O. to ask this specific question. There has been a lot of back and forth about whether BMI is still a relevant measure and we wanted to search for the answers. Dr. Rigatti practices the full spectrum of Family Medicine including: pediatrics, geriatrics, sports medicine and has a special interest in weight loss and exercise.

Before we even got into the questioning, Dr. Rigatti offered this bit of advice,

“It is important to remember that BMI is a screening tool that is derived from a formula: weight(Kg)/Height(meters squared). As such, it does have limitations in certain populations and needs to be considered as a part of the overall picture of the patient. Obese patients will have a High BMI, but so too will very muscular people who have a relatively small frame.”

He encouraged us to always look at the whole picture of health.

Pro-Activity: In your practice, what have you seen as the impact of elevated BMI on joint health over the long term?

Dr. Rigatti: Increased BMI's impact on joint health over the long term will be detrimental. It will result in a higher risk for arthritis and joint injury/disease. These patients will be at higher risk for joint replacement as they age.

Pro-Activity: For people with a significant amount of muscle tissue or a very heavy bony frame, is BMI interpreted the same? Should it be?

Dr. Rigatti: BMI will be elevated in muscular patients, or those with heavy, large boned frames. In those patients, one must look at waist circumference and measurement of (body fat percentage) skin folds with calipers or bioelectrical impedance analysis(BIA) for additional information. BMI should not be used exclusively.

Pro-Activity: For someone who has goals of getting fit, what is a reasonable change in BMI over the course of a year?

Dr. Rigatti: I set goals for weight (fat) loss , not BMI change. Remember, loss of muscle mass will lower BMI as well. That is not usually desirable. I recommend 12-25 lbs as a reasonable, sustainable goal for a year in an average patient. The more one has to lose, the higher that number can be though.

Pro-Activity: Kids appear to put on weight just before they hit a growth spurt. Should we be concerned about an elevated BMI in adolescence?

Dr. Rigatti: BMI has to be used very cautiously in the pediatric population, especially in adolescents. Again, one has to look at the whole patient, not just one metric.

Pro-Activity: For people in their 70's and on, as bone density decreases, is it still considered beneficial to have a low BMI?

Dr. Rigatti: Overall, yes a lower BMI would be beneficial in the elderly. But as I said earlier, loss of muscle mass(as well as bone mass) would be an undesirable way to see a lower BMI. We want a leaner patient, with a lower percent of body fat.

Pro-Activity: If people really want to improve their health and quality of life, in your opinion what's the "take home message" for the average American when it comes to health and prevention of injury and disease?

Dr. Rigatti: As a society, we need to reduce consumption of fat and carbohydrates and we need to move! The combination of abundant food and a sedentary lifestyle is causing the obesity epidemic and increasing the risk of obesity related diseases such as: diabetes, cardiovascular disease, some cancers, and joint disease. So eat less, eat healthier and exercise more!

We’d like to thank Dr. Rigatti for taking the time to answer our questions. In addition to being a Board Certified physician in Family Medicine and practicing at Pleasant Run Family Physicans and Sports Medicine in Readington Township on Route 202, he also plays a role as team doctor to our affiliate professional track team the New Jersey New Your Track Club. His personal interests include: distance running, skiing and martial arts. He resides in High Bridge, NJ with his wife and two children. If you’d like more information about Dr. Rigatti or his practices please let us know.