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'Flawed' body mass index being questioned for COVID-19 vaccine eligibility, but doctors explain why it's important

"I agree with the viewers," said Dr. Sarkar of the BMI being "a little bit flawed," but it's one of the many tools that can help determine a reaction to COVID-19.

HOUSTON — President Joe Biden is asking states to lift age requirements by May 1, so all adult Americans can become eligible for the COVID-19 vaccine. As of now, Texans must meet one of these requirements to qualify for a vaccine in the state: be a healthcare worker, live in a nursing home, work at a school or daycare, be at least 50 years old or at least 16 years old with a health condition that increases the risk of having a severe reaction to COVID-19.

Obesity is one of the qualifying health conditions, but since Texas doesn’t require anyone to show proof of their eligibility, some Houstonians have called KHOU 11 upset, with criticism of their neighbors who callers claim “don’t look obese.”

So KHOU 11 turned to the experts at Baylor College of Medicine for information about the body mass index, which is the measurement used to determine if a person is obese and qualifies for a COVID-19 vaccine.

“About 40 percent of America is considered obese,” said family doctor Arindam Sarkar who is also an assistant professor at Baylor College of Medicine.

Body mass index is calculated by inserting height and weight into a formula. Dr. Sarkar admits the BMI isn’t 100 percent, accurate because it doesn’t take into account a person’s bone density or muscle mass when placing them in one of four categories: underweight, normal weight, overweight or obese.

“Although the BMI was initially developed by a mathematician 200 years ago, and is sometimes used somewhat inappropriately by an insurance company to determine if you are healthy or not, it is a useful instrument that clinicians and public health epidemiologists can use to get a better sense of population data," Dr. Sarkar said.

CLICK HERE: Calculate your body mass index

A CDC study of more than 70,000 hospitalized COVID-19 patients from March 2020 to December 2020 finds nearly 51 percent were obese, and 28 percent were overweight.  

Another study done by the Tufts University Friedman School of Nutrition Science & Policy looked at more than 900,000 COVID-19 hospitalizations. At least one of four conditions --obesity hypertension, diabetes or heart failure -- was responsible for the majority of hospitalizations nationwide with obesity being the top risk.

The state is counting on Texans to be honest about their eligibility, so it’s possible some might lie about how they qualify. But when asked if everyone has to look obese to be obese, Dr. Sarkar said, “for decades we’ve known that this phenotype of ‘skinny fat’ exists,” with some Americans having a normal BMI but high blood pressure, high cholesterol or high triglycerides.

So to people who might be critical of some people in line for the COVID-19 vaccine, “just because someone appears to be skipping you in line doesn’t mean that you’re still not going to get the vaccine," Dr. Sarkar said.