Squating really helps actually. Your knees hurt because the supporting muscles around the knee get too weak over time due to lack of use. You can begin with bodyweight squats but weighted squats are even better
Overuse and traumatic injuries mostly. I've also sold my body to survive, so while age shouldn't be a factor yet, I'm probably ahead of average on duty cycles.
I do find it interesting your bias jumps (haha) to under-training and over-weightness first. Are they common problems in your circles?
I thought BMI was generally replaced with BMI + WC? BMI is certainly a useful population tool and quick heuristic, but lacks depth. But I've been out of this topic for a while.
I'm very confident my knee pain comes from load carrying. If I add the average load carried to my bodyweight, I had a BMI of >40 for over a decade, definitely falls on line with your theory!
I would guess external load doesn't have the same heart effect as body mass, but again, out of my depth.