A high BMI is strongly correlated to certain medical conditions, even if you’re elderly or of “old age.” A fat belly does not care how old you are, and elderly people with a high body mass index certainly do not get a free pass to good health just because of their age.

I asked a physician if old age is a legitimate excuse for high body mass index.

“No,” says Jacob Teitelbaum, MD, medical director of the Fibromyalgia and Fatigue Centers nationally, and author of “Beat Sugar Addiction NOW!”

“However, medical conditions such as diabetes, thyroid deficiency, and in men low testosterone will contribute to excess weight,” says Dr. Teitelbaum.

“These conditions, however, are sometimes missed, with the problem being ignored because it’s probably ‘due to the person’s age.’”

First, lack of structured exercise and being overweight are strong risk factors for type 2 diabetes – and very strong. As for low testosterone, strength training will raise levels of this natural fat-burning hormone.

In particular, intense weightlifting and intense cardio exercise in the form of high intensity interval training will increase the circulating levels of testosterone (as well as other fat-burning hormones like growth hormone).

So, one major key player in maintaining a normal body mass index is intense exercise.

Many young adults and middle-aged do not exercise at all, let alone intensely. It is they who are being set up for the high BMIs in old age. Ironically, they’ll end up blaming old age for their high body mass index.

A normal body mass index is 18.5 to 24.9.
Overweight is 25 to 29.9. Over 30 is obese. Since BMI involves measuring weight relative to one’s height, the resulting number can be misleading in the well-muscled athletes whose weight causes a BMI to be in the overweight range.

This is a well-known fact, and it’s why BMI is not an accurate tool for detecting body fat levels.

The tool for that is the skin fold test with calipers. The muscular athlete with the “overweight” BMI may have quite a low body fat percentage.

Being old or elderly is not a valid reason for a high body mass index. And what’s so bad about the high body mass index?

A BMI in even the overweight range is strongly associated with heart attack, stroke, type 2 diabetes and an increased mortality from all causes.

Thus, consider BMI to be a guideline to whether or not you are overweight. The body mass index is fairly accurate for indicating whether or not you carry excess weight in the form of fat, if you’re not an athlete nor very muscular.

It’s safe to assume that a BMI of 27, in a sedentary person, especially a person who is elderly, indicates this person needs to lose weight – fat weight.

It was long thought that losing muscle mass was an inevitable consequence of getting old.

However, more and more research shows that a significant amount of muscle can be retained well into old age, if a man or woman begins serious strength training earlier in adult life. Does this mean train for the Mr. Universe contest? No.

It means train hard with weights (e.g., barbells, dumbbells, machines) and go hard with the cardio exercise. There is no magic to retaining a svelte, lean body with trained muscle and a healthy BMI into old age; it’s dedication.

Dr. Teitelbaum is a board certified internist and nationally known expert in the fields of fibromyalgia, chronic fatigue syndrome, sleep and pain.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.