Obesity, Thinness, Body Mass Index and the Ayurveda Perspective to Measurement

How do you know that you are overweight and not naturally chubby, or abnormally skinny and not just naturally slender-framed? The typical answers that I get from patients are –

“By looking in the mirror?”
“Because I can’t touch my toes with fingers?”
“Because I ‘mind the gap!'” (“What?”)
“Because some dumb kids at school/college keep teasing me over it.”
“Because I’ve gone over 70 kg / under 50 kg now!”
“Come on Doc, I’m above 60 years now. Isn’t it but natural at this age?”

Really, is that it? Frankly speaking, it’s totally NOT!
And even if you do know from a doctor, how bad it really is? Let’s see how to measure realistically for ourselves.

image
Laurel and Hardy, the iconic comic duo.

The Modern View
Modern science provides a host of mathematical measures for scaling obesity/thinness, the most popular being BMI (Body Mass Index). This measure essentially denotes whether your weight is in tune with your height or not, since 60 kg can be too less for a 6 feet guy, but too much for a 5 feet one. So BMI is a scale for bringing everybody on the same base despite of height differences. How do we calculate it?

BMI = (Weight in kg) ÷ square of (height in metre)

Calculations illustrated
Some useful conversion factors first –
1 foot = 12 inches
1 inch = 2.54 cm
1 metre = 100 cm

So if your weight is 78 kg, and height is 5 feet 10 inches tall, you are (5×12)+10 = 70 inches in height. That becomes 70×2.54=177 cm, or 177÷100= 1.77 m. Square it (multiply it by itself) (1.77×1.77=3.13), and divide your weight by that square. (78÷3.13=24.91)
That’s your BMI: 24.91 , Ta Da!

Interpreting BMI
Now that we’ve got a number, what does it mean?

Normal BMI range differs quite a bit by race, gender, muscle-mass and age, amongst other factors. Still, a more or less general scale is as follows –

For men
Below 20 – Thin
20 to 22 – Normal
22 to 25 – Athletic
25 to 30 – Overweight
Above 30 – Obese

For women
Below 18 – Thin
18 to 21 – Normal
21 to 23 – Athletic
23 to 28 – Overweight
Above 28 – Obese

So this is the nearest measure that you can get at home with modern science, for your goal-setting, which is quite good as it gets. Still, it is limited, as I told earlier, by many factors, most importantly by muscle mass. Since BMI has no way of differentiating between weight due to muscle and fat, even fit and muscular people get wrongly classified as obese. Examples? Arnold Schwarzenegger has BMI 30.8, and Tom Cruise 26. On the other end of the scale, stands Angelina Jolie at 17.9!

Our ancient ancestors, however, had devised a very different, almost universal and way-too-simple scale of measuring body metrics, without having to adjust for any of these factors. It is known as the ‘Swaanguli Pramaan’ in Ayurveda.

‘Swaa…’ what?
Translated literally, it means ‘self finger-width scale’. This involves simply using a person’s own average finger width as a unit for measuring their body metrics. Average finger width is obviously different for each person, and so becomes a personalized basal unit of measurement as per their natural Prakriti (constitution).

How to determine your personal Swaanguli unit

1. cup you palm, keep the fingers (except thumb) of a hand straightly lined, not too tight not too loose, and run a ruler carefully at right angles to the fingers’ edge.

image
Measuring your own personal Swa anguli praman (unit).

2. Measure the width of the four fingers together, along a line that will cross each finger in between the finger-base and first (proximal) finger joint, as shown in the image.

2a. For the science nerds and medicos, measure using vernier callipers, such that it is measured across each proximal phalanx.

3. Finally, Divide the measurement by four to get your own self-finger width, or Swaanguli unit.

How it works (some science+math stuff)
Fingers are basically one of the few parts of the body, whose shape and size is influenced substantially by all sorts of anthropological factors like age, race, height, profession etc., excepting only body fat (since fingers are one of the last places where excess fat gets deposited). So the average finger width is somewhat like a unit total of your Praakritic dimensions, adjusted for all anthropometric factors excepting abnormal body fat. Using it as a unit gives us a universal scale on which all humans can be measured at par, but only for their individual body fat. So, if I say that the normal belly circumference is 36 to 40 Swangulis, it has already taken into account the adjustments to be made for your height, age, race, normal body fat etc., so that any fit person ends up having 36 to 40 Swaanguli wide belly, even if they have different metric measurements. Any deviations from the ideal number denote only the amount of fat that is excess or deficient.

Technical Note for AyurNerds
Not all Ayurveda experts will confirm to my measurement method. Samhitas specify no specific method of determining Swaanguli. Everybody interprets it based on their own experience and word of tradition. Some contemporary professors have suggested measuring across the proximal interphalangeal joint of middle finger. However it gives significantly incorrect measurements for people having this joint previously affected by arthritic pathologies. Also, it doesn’t discount the natural fat cover of the body, as there are only tendons over that joint, and negligible fat. So this is the method I prefer personally, and though unreviewed, this “Rajandekar method” has never failed me.

How to interpret Swaanguli measures

Circumferences –
Waist – 36 to 40 Swaanguli
Mid thigh – 24 Swaanguli
Calf – 16 Swaanguli
Base of calf – 14 Swaanguli

A deviation of more than +/- 20% (one-fifth) from these measures is generally considered pathological, and should be taken a consult for.

The added advantage of this method is that, not only does it diagnose obesity/ thinness, but also points out the distribution pattern of fat on individual body parts, which has significant value in diagnosis of several other diseases / conditions too.

Bonus: Some other clinically important standard measures –

* Mouth width – 4 Swaanguli (for plastic surgeries)
* Forehead height – 4 Swaanguli (same)
* Adult female hip circumference – 24 Swaanguli (for assessing normal child-bearing capacity).
* Knee circumference – 14 Swaanguli (for assessing chronic arthritic swellings)

So now you know exactly, both the modern and ancient way to assess your fitness and the red flag limits within which you can control obesity/thinness with just diet and lifestyle changes; and when to consult a doctor.

Where to go from here?
Like this article? Want more info? You can follow this blog using a free WordPress account to get new articles and updates directly by email. More articles on this topic will be out in the future. Medical opinion for any brief queries can be asked in the comments box below, or here. For detailed consultations, we also offer professional consults by email and in person (More info about consulting services here). Also, don’t forget to like and share this article on social media/WordPress using the buttons below.

About the Author
Dr. Harshad Rajandekar is a practising physician based out of Nasik (India), licensed to practice Ayurvedic, modern and integrative systems of medicine. He consistently explores innovative approaches to build comprehensive holistic care protocols combining the best of old and new knowledge.

Disclaimer
This article is for patient education and informative purposes only. Nothing in it should be supposed or construed to replace or substitute professional advice in serious medical illness, or act as medical education.

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