Is The BMI Number Reliable?

My doctor told me my BMI is higher than it should be and I should 'lose a few pounds'. I am a 50 year old male who is 5'9" and I weigh 198 pounds--is this really too much if I am in good shape? (I do a lot of yard work at home on weekends and during the week I supervise construction at work--it's a lot of walking).
Phil S.

Dear Phil,
Your BMI (body mass index) is a number based on a calculation using your height and weight. (You can perform the calculation, but it's easier to just go to a tool that calculates it for you in seconds: http://www.nhlbisupport.com/bmi/). Yours is 29.2 which is at the upper range of "overweight" according to the chart.

The numbers are categorized as "normal weight", "overweight", "underweight", or "obese" (the latter if your BMI is 30 or greater). These ranges are based on health risks seen over years of study and observation by medical professionals.

Some people argue this number is too "black and white" and doesn't take into account things like age, gender, or physical fitness. In fact, a 26 year old football player who is 5'8" and weighs 200 pounds is certainly less likely to be at risk for the same chronic diseases as a 48 year old woman who is the same height and weight. Yet both have the same BMI--30.9--which measures as "obese" on this particular scale.

So, each individual must use some of their own judgement when deciding whether this reading is meaningful to you. As a dietitian, the people I have seen who are over "ideal" weight are usually not in great shape. You didn't mention if you have an existing condition such as diabetes, hypertension, chronic heart disease or high cholesterol. Certainly, if you do, any health professional would encourage you to lose weight and aim for a lower BMI, despite objections that you really are in good shape (or, the objections of some people that they are just "big boned").

Frankly, it doesn't sound to me like you are someone who would have a large amount of muscle mass as a result of doing a lot of walking and some moderate exercise. At some point I would suggest you take a long, hard look at how you really feel and see if you don't end up acknowledging that you could--and would--be in better shape if you lost a few pounds.