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Am I too short for my weight?.

01 August 2008 Doctor Peter Bond, Old Mutual

Financial advisers might sometimes be confused at the emphasis life insurance companies place on Body Mass Index (BMI) when it comes to underwriting risk products. Being a bit overweight isn't so serious is it ?

The word obesity might also seem insulting to some people yet it is, in fact, a medical term for a very serious condition. It is so prevalent and increasing so rapidly in all parts of the world that the term Globesity has been coined now that this condition has reached pandemic proportions.

Globesity – a worldwide pandemic

In 2005 there were 1,6 billion adults worldwide who were overweight and of these, 400 million were considered obese. In 2015 these numbers are expected to increase to 2,3 billion and 700 million respectively. This pandemic is expected to further increase across all age groups for many years. It is anticipated that by 2015, for the first time there will be more people in this world who suffer from obesity than from starvation (source: WHO Fact Sheet 311, 2006).

Body Mass Index (BMI)

BMI is a simple calculation of a person's height in metres squared divided into his/her weight in kilograms. The BMI is then rated according to the World Health Organisation classification below.

ClassificationBMI (kg/m2)
Underweight18.50
Normal range18.50 - 24.99
Overweight25.00 – 29.99
Pre-obese25.00 - 29.99
Obese = 30.00
Obese class I30.00 - 34.99
Obese class II35.00 - 39.99
Obese class III = 40.00

Source: WHO 2000 / 2004

There are more accurate ways to measure obesity risk than purely weighing someone and calculating the BMI. These include waist measurement and waist-to-hip ratios.

The risks

Risk factors associated with obesity are numerous. Heart disease, stroke, high blood pressure, type 2 diabetes, sleep apnea, liver disease, gall bladder disease, osteoarthritis, cancer of the breast and uterus in females and the liver in men as well as the colon, pancreas and kidney, are all associated with obesity.

Being overweight can worsen your health and shorten your life because of increased risk and this is why insurers are so interested in BMI.

Increased BMI – how many years does it cost?

BMISmoker statusReduction of life expectancy
(at age 40)
25-30Non smoker3 years
30Non smoker6-7 years
30Smoker13-14 years
Source: Peeters A, Barendregt JJ, Willekens F et al. Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis. Ann Intern Med 2003; 136:24-32.

Solutions

There is extensive evidence that individuals who battle to lose weight but remain fit from a cardio-respiratory point of view have essentially the same mortality and morbidity outcomes as an unfit individual of normal weight. In some cases they might even be better off.

Medicine can also help with the side effects of obesity. There is a pill available for just about all the ravages of obesity for those living in a country with a developed healthcare system. Provided one takes the medicine correctly, the overall risk posed by the obesity scourge can be mitigated.

The bottom line

By whichever method an individual is considered obese, the risk of future disease is huge. This increased risk affects risk cover premiums. Management of obesity itself before the onset of risk factors is one of the most cost effective and gratifying treatments of all.

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