Who are you calling fat?

Four of these men are obese - but didn't know it, until we stepped in

By Denise Winterman BBC News Magazine

Britain is the fattest country in Europe and part of the problem is people don't realise they are overweight, says the government. So what does obesity look like?

How hard can it really be? The rolls of surplus flesh, the tight waistband, not being able to see your own feet - you don't need to be a rocket scientist to work out you're carrying extra pounds.

But many people don't consider themselves overweight, according to fitness minister Caroline Flint, who says it's one reason why nearly a quarter of adults in the UK are obese.

OVERWEIGHT ACCORDING TO BMI George Clooney Brad Pitt Matt Damon Calculate your BMI

The government and doctors use the body mass index (BMI) to assess a person's condition; classing us as "underweight, ok, overweight, obese or clinically obese". The calculation is based on comparing a person's weight with their height and does not take into account sex or the proportion of body fat to muscle.

Some medical bodies, including the World Health Organization, say waist size is a more accurate measure, but the government has no plans to ditch the BMI.

"We are aware of criticism and that there has been talk of the hip-to-waist ratio, but BMI is the agreed system and we will continue to use it," says a Department of Health spokeswoman.

So what does obesity look like? The Magazine headed to Stratford, east London, to break the unhappy news to some unsuspecting men, who significantly outnumber women in the fight against fat.

ZAC GOBI - 6FT 4INS - 18 STONE - OFFICIALLY OBESE

"Obese! Not even just overweight. That is a bit of a shock. I think it's ridiculous, I'm 6ft 4ins so I'm never going to be as light as a feather. I think my weight is fine for my height.

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"To get to the weight slap in the middle of what the index says is right for a man of my height I would have to lose around five stone. That's madness, I'd look ill and as if I had a massive head.

"I eat one big meal a day, it is a really big meal - maybe a whole chicken, rice and peas.

I think the amount I eat and my diet is good. There is a problem with weight in this country but the index is confusing. It doesn't take into account things like muscle."

BILLY MURRELL - 5FT 8INS - 14 STONE - OFFICIALLY OBESE

"No way. I don't agree with that - it's crazy. I know I'm carrying a few extra pounds and I am having a cheeseburger for breakfast, but obese? I'm just eating this to kill a bit of time before an appointment, I don't usually have a burger for breakfast.

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"That classification isn't any good because it doesn't take into account my body frame, muscle or what sex I am, all of which make a difference.

"I'd have to lose around three stone for the government to think I'm the right weight, That's just stupid. I'd look ill and I probably would be ill.

"I know the government has to have a way to measure weight, but this is not it. They need to look at things again."

ANDY WOOD - 6FT 2INS - 16ST 11LBS - OFFICIALLY OBESE

"I know I'm carrying a little bit of extra weight but I'm not obese. I think I am a fair weight for my height and build.

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"The BMI doesn't take into account things like muscle, which is important. It would class most rugby players and footballers as obese and look how fit they are.

"According to the index my healthy weight is around 12 to 13 stone, but I actually think that is underweight for my height.

"There is a problem with obesity in this country, people don't eat well or look after themselves. But using the BMI is not the right way of assessing the problem, it's not very helpful."

BRIAN MANSFIELD - 5FT 11INS - 17 STONE - OFFICIALLY OBESE

"I knew it would have me as obese. I know I am packing a few extra pounds, but I don't consider myself obese.

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"I'm big boned but the index doesn't take that into account and it should. I do drive a cab, which means I'm sitting on my bum all day but I wouldn't say I was unhealthy.

"I have lost weight in recent months. I did it by eating healthily, my wife does all that stuff - salads and that. She looks after me very well.

"The BMI is not a helpful way of calculating who's overweight and not. The problem is if people don't trust it they're not going to trust what else the government says about being healthy."

LEE EMBERY - 6FT 2INS - 15 STONE - OFFICIALLY OVERWEIGHT

"I think that's a bit harsh. I know I could do with losing some weight, but only a few pounds.

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"I'd have to lose about two stone to get to what the government thinks is the ideal weight for me. It's ridiculous, I would look ill, look like a skeleton. I would not look healthy.

"I know there are some things about my eating habits that I could change but on the whole I don't consider myself unhealthy.

"I'd like to see what some of those government ministers are classed as using this index. I would like to see how they react to being called fat."

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I'm a male 5'8" and 12Stone. If I was built like George Cluney then the BMI wouldn't fit me but then I wouldn't have a double chin or love handles so I guess that I need to loose some weight. The problem is that because so many people are overweight being a bit chunky has become the norm and doesn't look out of place. However the fact of the matter is, if you are overweight then you increase your chances of dying before you should. So be fat or not but don't criticise the government for giving a simple guide to help you.
Paul, Glasgow

Current thinking is that a person's waist measurement is a more accurate way of seeing if they are obese. Many athletes, i.e. weight lifters, shot putters, etc. are very large but it is all muscle and would show as obese if bmi was used.
JILL BOND

I look at these pictures and see men that, mostly, look reasonably healthy. Maybe Britain's problem is not obesity but the BMI index. Its just another nanny state scare story.
Mike Ayres, Bodmin, UK

I challenge all members of parliament to have their weight checked against the BMI index and see how many of them come out overweight and obese.
maureen hodgson, telford shropshire UK

I'm sorry but I think many people in Britain are deluded about their weight. It is easy to disguise several stone of excess flesh by dressing carefully. However, the internal threat to our systems is there none the less. Stay fat if you like but be prepared to suffer the consequences of your denial!! Healthy eating is just a good habit we need to practise. Unhealthy eating is just a bad habit we need to give up. Not rocket science.
OmegaSarah, Huntingodn

These five men are in denial about their size. Of the four men you can see none of them look healthy, they are just hiding their bodies in lose fitting clothes. They all look overweight to me and could do with losing more than their suggested few pounds. Lee Embery sums up public perception of weight when he says "I'd have to lose two stone ... I would look ill, look like a skeleton". People don't see being overweight as looking ill they see being lean as ill. Even though the people with BMI index in the lower half of the ideal weight section have the least health problems.
Andrew Campbell, Southport, UK

Maybe the BMI takes it's baseline from the skeletal celebrities/models rather than real people? Not to take muscle into account is ridiculous as it weighs so much more than fat.
Sue, Cheshire

ig Boned? Given that your skeleton accounts for just 15% of your body weight it's clear that even if you had bones half as big again as the next person this isn't going to have much effect on your overall weight. Lay off the pies, and you'll end up with the correct BMI; people are just kidding themselves.
Ewan, Newcastle Upon Tyne

What a horrible world it would be if everyone conformed to this meaningless measure, and we all pottered about half starved, in our joyless feable frames. Thank god we still have the right to live our lives the way we want to, for now.
Steve Alcock, Colchester

According to the BMI Jonny Wilkinson is overweight and the likes of Lawrence Dallaglio are obese. Need I say more?
Steve Ferris, Gloucester

I have to say I agree with these blokes - they all look fine to me! I am in the ok weight-range on the chart, but then I am female so probably have less muscle than these guys, who all look ok to me. As they say, maybe a couple of them could do with losing a few pounds, but I certainly wouldn't class these people as obese...or even overweight in most cases! Very interesting - I thought BMI was a good way of measuring if someone was overweight or not, but now I'm not so convinced.
Rebecca, birmingham

Its crazy madness i tell you, none of those men look obese!! The chap who uses the example of rugby players is spot on, muscle weighs a lot more than fat. I went ona diet, exercised, changed shape and went down two dress sizes, but for the first few months i put weight on, as i was building muscle. I was told by a qualified fitness instructor NOT to weigh myself as it is misleading!! Utter rubbish this BMI scale, but unfortunatly it needs to be measured, just in a more realistic way.
Suz, Gloucestershire

I am a weight lifter and runner. I ran the Nike Run London 10km in 54 minutes and today I benched 120kg in the gym. At 6'1" and 105 kg I am obese according to the BMI.
Philip Duran, London

I'm 18 years old, and have lost 5and 1/2 stone in just over a year. My BMI states that I am right in the middle, if not towards the top end of the right weight for me (being 5ft 8 inches, weighing 1o stone 5 pounds) yet some people in my family have recommended that I need to put on 1/2 a stone to be at the right weight. I think that all the BMI can be used for is a vague benchmark for people, and is unreliable, and inaccurate.
Richard Durkin, Sheffield

Well, I'm 6'4" and approx 85kgs so with a BMI of about 22.5. Recently I weighed about 10kgs more than that, realised I was getting podgy and lost the weight. It's really not that hard, you've just got to stop deluding yourself that you're healthy. Theres a hude difference between International Rugby players and us common mortals.
Duncan, Cambridge

I'm 5'7", about 14st, broad-shouldered and stocky. The charts say I'm around 3.5st too heavy, and class me as obese. The charts lie. I had a medical a while ago (I weighed more then) that measured my actual body fat percentage. They calculated my ideal weight range to be only 1-2st less than my current. BMI is a fiction that succeeds only in setting unachievable targets, and making healthy people feel insecure in themselves.
Jon, Cambridge UK

Scanner could reveal hidden fat

The scan can pinpoint the exact distribution of

A body scanner could help fitness fans work out exactly how much of their bodies are made up of fat.

Doctors could use the device - developed by UK scientists - to look for abnormal fat which may be putting their patients at risk.

Scientists at Lancaster University and the Institute of Food Research in Norwich used radiowaves to detect fat beneath the skin.

It is hoped that such machines could be commonplace in leisure centres one day.

The device works on the principle that the human body is a mixture of water and fat.

The amount of fat on a person can be calculated by working out their density using their exact volume and weight.

Other methods pass a tiny electrical current through the body - the level of resistance to the current can be used to estimate fat content.

However, none of these methods is particularly practical to be used in seriously-ill patients - or ordinary members of the public who need an easy way to find out the truth about their bodies.

Field method

The new method, revealed in New Scientist magazine, involves passing coils which create a radio-frequency electromagnetic field over the body.

The make-up of the object within the coil alters the phase of the field - and this can be measured and used to estimate the water content - and hence the fat content.

We should be able to put something like this in a leisure centre and members of the public could use it on a regular basis Dr Henri Tapp, Institute of Food Research

When this information is coupled with an exact measurement of the body's volume collected by four lasers sweeping across it, the researchers can in theory create a rough picture of not only the amount of fat, but also its location on the body.

Dr Henri Tapp, from the Institute of Food Research, told BBC News Online: "The technique is called magnetic induction tomography - it has been around for a while, but it is the first time it has been used this way.

While traditional measures of obesity, such as body mass index, can help doctors predict the risk of diseases such as diabetes or heart disease, there is increasing evidence that the precise location of that fat - whether it evenly distributed or located around the waist - also has a bearing.

'Fat scan' shows up health risk

Fat appears white on the MRI scan

A scan can spot which people harbour dangerous levels of fat around their vital internal organs, scientists say.

Hammersmith Hospital, in west London, is currently the only hospital in Europe using the MRI scan.

Its scientists say 40% of the population have "bad" fat around the heart, liver or pancreas, even though many appear thin. Only a litre of fat should surround these internal organs. People who are thin but do little exercise often exceed this amount.

They warn it is possible to be slim and yet still be at risk of conditions like diabetes because of "hidden" fat.

Evidence suggests the precise location of fat has more of a bearing on health than simply being overweight.

For example, people who have too much weight around their middle, often called an "apple" shape, have a greater risk of developing heart disease and type 2 diabetes than those who are pear shaped and carry the weight around the hips.

Fat is good in general, but when you have too much of it or fat in the wrong places it is bad Researcher Professor Jimmy Bell 'I'm fat on the inside'

While doctors can check whether a person is a healthy weight for their height by calculating their body mass index or BMI (weight in kilograms divided by height in metres squared), they cannot see the dangerous hidden fat.

Lead researcher Professor Jimmy Bell, a Medical Research Council scientist, explained: "One of the problems with BMI is it gives you the wrong idea of how much fat you have.

"It's about where you have the fat.

"Fat is good in general, but when you have too much of it or fat in the wrong places it is bad.

"Someone can look really thin and have a normal BMI but have seven litres of fat inside them when they should ideally only have one litre."

Once doctors are aware someone has dangerous levels of hidden fat, they can work out the right combination of exercise and healthy eating needed to shift it, Professor Bell said.

He explained: "We are trying to understand what factors - genetic and environmental - make people put on fat internally and then determine what people need to do to get rid of this fat.

"When you diet you don't lose the right type of fat. If you exercise you lose more of the bad fat.

"If people are only going to do an hour of exercise a week, let's make sure that hour is spent doing the right exercise to shift the important internal fat."

Every 5 minutes somebody in the UK dies from a heart attack

A chest pain is your body saying call 999!

View the British Heart Foundation campaign launched 26th November 2006.

A huge poster already spotted at Eastcote last week.

Download the Doubt Kills campaign poster here

Listen to the first Doubt Kills radio advert here

Listen to the second Doubt Kills radio advert here

Coronary heart disease is Britain’s biggest killer. Almost one in five men and one in six women die from this disease.

However, for people with diabetes the risk is much higher. Among those who have diabetes,women have a greater risk of developing coronary heart disease than men. Women with diabetes are three to five times more likely to develop coronary heart disease than women without diabetes. Men with diabetes are two to four times more likely to develop coronary heart disease than men without diabetes.

Diabetes Test

Sharon got her Capillary Plasma Glucose (Random) tested. It was 4.9 millimoles per Litre . All ok. But mine was 6.1 mm/L. Which is borderline fail (range 6.0-12.0mm/L). I'm on a fast tonight. The next day the fasting test gave a result of 5.9mm Glucose/L. A retest is required in 3 years, according to the nurse.

From Lloyds Pharmacy - a Free Diabetes Test:

There are 1.8M diagnosed with diabetes in the UK. There are thought to be up to 1 million people undiagnosed with Type 2 diabetes in the UK. That is why Lloydspharmacy are working with Diabetes UK, (diabetes myths) the charity for people with diabetes, to offer a free diabetes tests to help identify your risk of developing the condition.

Unfortunately, by the time that many people are diagnosed with diabetes they have already developed serious complications. Long term complications associated with diabetes include:

• High blood pressure
• Coronary heart disease and stroke
• High cholesterol
• Eye damage and blindness
• Kidney failure
• Nerve damage
• Leg ulcers

We can check your blood glucose level by doing a simple test which is available to anyone aged over 16. Our pharmacists can also advise you on ways of reducing your chance of developing diabetes later in life and offer guidance on leading a healthy lifestyle. The service is free and no appointment needed (dont eat or drink for 2 hours before the test).

To get a diabetes test, please use the pharmacy finder to find your local Lloydspharmacy.

What is diabetes?

Diabetes is a condition in which the amount of glucose (sugar) in the body is too high because the body is unable to use it properly. Glucose provides the body with energy and is mainly obtained from the digestion of starchy foods such as bread, rice and potatoes and from sugar and other sweet foods.

After eating, the level of glucose in the blood increases and the pancreas releases a hormone called insulin. Insulin regulates your glucose levels to prevent them from becoming too high or too low. If you have diabetes, the body either produces too little insulin, or resists its effects. The body then uses other sources of energy and unused glucose builds up in the blood.

Download the diabetes leaflet (PDF document)

Diagnostic criteria ex Wikipedia

Diabetes mellitus is characterized by recurrent or persistent hyperglycemia (high glucose levels), and is diagnosed by demonstrating any one of the following:^[1]

• fasting plasma glucose level at or above 126 mg/dL or 7.0 mmol/l.
• plasma glucose at or above 200 mg/dL or 11.1 mmol/l two hours after a 75 g oral glucose load in a glucose tolerance test.
• random plasma glucose at or above 200 mg/dL or 11.1 mmol/l.

By definition, two fasting glucose measurements above 126 mg/dL or 7.0 mmol/l is considered diagnostic for diabetes mellitus.

Patients with fasting sugars between 6.1 and 7.0 mmol/l (110 and 125 mg/dL) are considered to have "impaired fasting glucose" and patients with plasma glucose at or above 140mg/dL or 7.8 mmol/l two hours after a 75 g oral glucose load are considered to have "impaired glucose tolerance". "Prediabetes" is either impaired fasting glucose or impaired glucose tolerance; the latter in particular is a major risk factor for progression to full-blown diabetes mellitus as well as cardiovascular disease.