The Energy Storage Capacity Model
Unfortunately, assessing BMI is not prognostically effective in attenuating obesity. Long-term weight loss for those who are already overweight and obese is elusive. 17-19 A "low risk" adult BMI that increases from low normal to high normal (eg. BMI 20 to below 25) represents an increase in excess weight of approximately 10 kilograms. Using BMI cutpoints to signal an appropriate point for intervention may miss the therapeutic window of an effective early response for the primary prevention of overweight and obesity.
In addition, the heterogeneity of disease risk by BMI status across ethnic populations, 20-25 as well as the heterogeneity of prevalent chronic disease within obese populations 26-30 indicates that BMI is either an insensitive or an invalid measure to characterize the obesity-disease association.We in fact, question the validity of the current obesity-disease paradigm for which the BMI represents. Synthesizing cross-disciplinary research findings in the areas of molecular science, animal experimentation, clinical studies, and epidemiology, we propose a modified obesity-disease paradigm that unifies existing obesity-disease theories, and explains the many paradoxes observed in the study of obesity and obesity-related disease. The editors for the International Journal of Epidemiology wrote in a 2001 editorial on "correct epidemiology", thatâ€¦ "Being right for the wrong reasons can be fine as far as short-term public health outcomes is concerned, but can be a severe impediment in the long term. â€¦that continued reliance on an unmodified miasma paradigm would have constrained the development of later thinking regarding the control of infectious disease." 31
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