Inadequacy of BMI as an Indicator for Bariatric Surgery
Edward H. Livingston, MD
In response to overnutrition, some patients preferentially accumulate peripheral rather than central fat, preventing development of the metabolic syndrome.
When the ability to accumulate subcutaneous fat is limited, overeating results in central obesity and ectopic fat deposition that causes insulin resistance, diabetes, and ultimately life-limiting cardiovascular disease.
Thus, fat distribution, not overall fatness, is a critical determinate of the health risks of obesity.