DEAR DR. ROACH: About seven years ago, my blood pressure was high, and I was overweight and in a stressful job. I quit the job, my blood pressure went down, and I lost over 40 pounds. I have kept the weight off all these years. I work part time, standing on my feet about 25 hours a week. My doctor has been happy with me. At my last appointment, I was told my BMI is too high and that I am obese. Where did this “BMI” come from? I am 5 feet, 6 inches tall and weigh 194 pounds. I am a largeframed woman (I delivered 12-pound babies through NATURAL childbirth!). Now I feel like I should forget it and go back to eating what I want, when I want! — P.S. ANSWER: BMI, the body mass index, is a way of determining obesity by standardizing weight for people of different heights. It is equal to weight (in kilograms) divided by height (in meters) squared. BMI predicts the development of Type 2 diabetes, heart disease and even overall mortality rates moderately well. It is certainly not a perfect measurement. Someone whose BMI is obese (over 30) might have very little body fat; he or she might be very muscular or have larger bones than another person of the same height. Some physicians measure waist circumference, since that looks at abdominal fat, and research shows that using both measurements gives a more complete
picture of health. Personally, I congratulate you for getting and keeping off 40 pounds, and think you made a wise investment in your health by finding a less-stressful job. Your BMI is 31, just in the “obese” range. However, women of your BMI but whose waist circumference is less than 31.5 inches (80cm) have a much lower risk of medical complications later. By the way, having babies that large does indicate an increased risk for Type 2 diabetes later in life. Your doctor hopefully is checking you periodically. Getting regular exercise and eating a good diet reduces your risk for Type 2 diabetes and heart disease, so please don’t get frustrated by this single, incomplete measure of your health.
. DEAR DR. ROACH: Last night I washed my face with soap and water. I toweled dry and saw blood dripping from the side of my nose. I figured I must have scrubbed too hard and opened a pore. This pore bled and bled for over an hour before I used styptic powder. That stopped the bleeding instantly. Now I’m
afraid to wash that area, as it may start bleeding again. I’m 61. I don’t take any medication except a baby aspirin every night, and Aleve when my arthritis kicks up. Is this common? — J.R.
ANSWER: No, that isn’t common. It makes me concerned that the pore you think is bleeding actually may be a subtle or early skin condition predisposed to bleeding. The ones I am most concerned about are basal cell and squamous cell cancers. See a dermatologist and get it examined.
Aspirin and naproxen (Aleve) do make bleeding more likely, but I still think you should get it looked at.
. Dr. Roach regrets that he unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med. cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.