Nathanael “Nate” Thompson, football player and sophomore, said he knows he weighs more than he should.

On the scale, he weighs more than expected for his height. Standing 6 feet tall, Thompson weighs 190 pounds, which puts him at 25.8 on the Body Mass Index (BMI) scale. According to the scale, he is “overweight.”

But Thompson said he considers himself perfectly healthy. According to Thompson, his body is maintained by frequent workouts, a routine that consists of a visit to the weight room almost every day and sometimes on the weekend.

“I’m not worried about my health at all. I’m in a lifting class so I’m staying in shape that way, and as far as eating goes, I’m not eating (unhealthily) at all,” Thompson said.

According to a recent article by Time Healthland, being metabolically fit and overweight is considered healthier than appearing thin yet carrying a lot of fat on the inside. Moreover, physical fitness — irrespective of weight — is a strong predictor of whether somebody is metabolically fit, and those factors are often overlooked when the typical population views statistics that indicate what “acceptable” levels should be.

Kevin Wright, advanced physical conditioning teacher and varsity football coach, said he agrees that muscle mass plays a large role in health.

“I think what students should be judged on probably has a lot more to do with body and muscle fat as opposed to body weight,” Wright said.

Doctors use BMI to calculate whether one is in the normal weight range by measuring his height and weight. But as people like Thompson have realized, it does not take muscle mass into account. This leads many to ask the question: How many people have been labeled overweight simply because they have a large muscle mass?

Thompson said there are many.

“I would say a good majority of the people go through the same exact thing as me. (When you) get working out enough, you’re going to keep gaining weight and that might label you as overweight. So I would say a good majority of the football team at least (would be labeled overweight), or at least guys that are in the weight room all the time trying to get better,” Thompson said.

Keith Chitty, Pediatrician at IU Health North Hospital, said he disagrees with Thompson that many people in America are overweight because of muscle mass.

“I would guess that (the amount of people that are overweight because of muscle mass) is way less than 1 percent of those people (who are overweight). I can tell you that out in the community, the vast majority of people who are labeled overweight have a lot of fat, so that is a pretty small sub-segment of people,” Chitty said.

Also, according to Amy Rivers, student nurse at St. Vincent Hospital, there can also be dangers by using the BMI scale. She said people who are classified as overweight but actually healthy could attempt to lose weight by unsafe methods.

“If a kid is told (he is) overweight, (he) can take that the wrong way and maybe start to become anorexic or start trying to lose weight on purpose when (he) shouldn’t, when (his) health,” Rivers said. “That can cause some problems depending on the ways (he tries) to lose weight. A lot of kids will use things that are very dangerous and that can make them sick.”

She also said people who are overweight and unhealthy but think they are healthy could potentially keep gaining weight.

Chitty said he agrees with Rivers and therefore analyzes the few people who are overweight because of muscle mass differently than those who are overweight because of fat.

“I don’t really think (labeling someone who is overweight because of high muscle mass) is accurate,” Chitty said. “I can tell you that if I saw a kid in my office who was like a body builder and had no fat on him and the BMI chart said he was overweight, I would tell him: the chart says you’re overweight but you’re not overweight you’re fine. This is probably something you see at high school in a few people.”

Thompson, however, said he had a very different experience at the doctor’s office.

“(My doctors say) that technically by whatever standards, you’re overweight but honestly I don’t feel overweight,” Thompson said. “But as far as the doctor goes, I remember a time when he did say if you gain too much more (weight), you’re going to be flirting with the obesity line.”

Wright said there are much more accurate ways to measure health than BMI. For example, he said cardio fitness is very important. Also, comparing muscle percentage to body fat percentage can be useful as well.

Thompson said he agrees with Wright.

“I think (health should be judged) by conditioning tests and sort of a way to track your diet, so what you’re eating and physical tests,” Thompson said. “Muscle index should play a factor too.”

There are many instruments that can be used to calculate muscle versus body fat percentage. One of the most common methods, according to Wright, includes using specialized calipers, which can be used to pinch skin in various areas and come up with a raw numeric score for body fat composition.

However, Chitty said that using BMI is perfectly acceptable.

“I wouldn’t change (the use of BMI). I think it works really well for the majority of patients,” Chitty said. “You’ll have some false positives, meaning you’ll have some people that aren’t truly overweight that will fall into that category, and then it’s easy to sort of tell them it’s okay: even though the system says you’re overweight, you’re fine. But you still catch the people that truly are overweight.”