The Body mass index (BMI) is a marker for health &amp; obesity. It can be measured using the following formula: weight (kg) ÷ height² (m²) BMI indexes:<ul><li>18.5&gt; is underweight</li><li>18.5 ~ 24.9 is normal</li><li>25 ~ 29.9 is overweight</li><li>30&lt; is obese</li></ul>

What is BMI?

Health

Using a <a href="https://www.google.com/amp/s/elemental.medium.com/amp/p/7d8dc2aa33bb" rel="noopener noreferrer" target="_blank">weight-to-height index devised by Adolphe Quetelet</a> in 1832 (the Quetelet index), Dr. Ancel Keys coined the term "body mass index" as a convenient way to measure relative obesity. He judged BMI as inappropriate for individual evaluation.However, it is widely used for preliminary diagnoses today.

History of BMI

The BMI scale cannot be applied to everyone (especially women &amp; POC) because it was developed by studying European men — and thus does not take into account racial &amp; sex differences.It is also an inaccurate measure of body fat content because it does not take into account muscle mass, bone density &amp; overall body composition.

The BMI scale is innacurate

<ul><li>Asians may have increased health risks before their BMI qualifies as overweight due to their tendency to hold abdominal fat.</li><li>Athletes tend to have heavier bones &amp; more muscle mass, resulting in higher BMI but may NOT be unhealthy.</li><li>Pregnant/nursing Women typically have higher BMIs due to higher body fat percentage, but may NOT be unhealthy.</li><li>People aged 65+ with a higher BMI tend to have more muscle mass, which has a protective effect in terms of overall functionality.</li></ul>

How innacurate is BMI?

Research shows that BMI is a reliable estimate of health risks.Plus, it’s convenient, cost effective, &amp; accessible in all healthcare settings.

Why do health-care providers still use BMI?

<ol><li>For a more accurate assessment of health risks. (Factors such as age, gender, race, medical history, exercise, nutrition, stress, etc, should be taken into account.)</li><li>To prevent weight bias, in which doctors assume that the patient's higher BMI is the cause of their diagnosis, leading to poor quality healthcare.</li></ol>

Why should there be alternatives to BMI?

<ul><li>Waist-to-hip ratio: measures abdominal fat. It's convenient but does NOT consider different body shapes/muscle & bone mass.</li><li>Body fat percentage: dinguishes between fat mass & fat-free mass and more accurate. However accurate measuring equipment is expensive & inaccessible.</li><li>Lab test: various blood & vital signs measurements to indicate health risks. More accurate but NOT convenient (need multiple tests to be accurate).</li></ul>

Alternatives to BMI

While there are alternatives to use in place of the BMI scale, each tool comes with its own advantages and disadvantages.Thus, healthcare providers should use the available alternatives together with the BMI index to obtain a more accurate reading of their patient's health risks.

Conclusion

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How BMI Came to Define Obesity, and Why This Measure Is Flawed

Body mass index is a common measure of body weight, but for certain people, it's not an accurate health marker.

Many people have been there: You go to the doctor’s office, get your blood pressure, height, and weight taken, and the doctor relays the unfortunate news: Your <a href="https://www.everydayhealth.com/diet-nutrition/bmi/">BMI </a>is too high, and you need to lose weight.

<a href="https://www.everydayhealth.com/diet-nutrition/bmi/bmi-adults-yours-healthy-not-how-can-you-lose-weight/">Adults can measure their BMI </a>by taking their body weight in pounds, dividing that value by the square of their height in inches, and multiplying the result by 703. Or check out the <a href="https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html">CDC’s BMI calculator </a>if math isn’t your thing.

<ul><li>Below 18.5 is underweight </li><li>18.5 to 24.9 is normal </li><li>25 to 29.9 is overweight </li><li>30 and over is obese </li> </ul>

If this formula seems complicated and somewhat arbitrary, that’s because it is. And many experts have started to question BMI's accuracy and usefulness.

In fact, BMI is far from perfect, and as the years have passed, more and more science has emerged that reveals the flaws of this approach.

Before delving into what exactly those imperfections are, it’s important to understand not only BMI’s history but also what your BMI number suggests about your health — and why you shouldn’t necessarily jump into panic mode if your doc says your number is too high.

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In the study, Dr. Keys looked at about 7,400 men from five European countries and analyzed their adiposity-body density and subcutaneous fat thickness, two measures of body weight. Using a weight-to-height index devised by Adolphe Quetelet in 1832 (called the Quetelet index), Keys came up with the body mass index as a straightforward way to measure body weight in relation to height.

As more people became more overweight, and the health risks associated with being overweight became clearer, epidemiologists around the world began using Keys’s body mass index approach as a way to track disease <a href="https://www.everydayhealth.com/diet-nutrition/bmi/high-bmi-risk-factors-how-help-prevent-obesity/">risk factors </a>in the general population.

How Experts Use BMI, and What Your Number May Say About Your Health

That simple number can affect your healthcare. Having a high BMI may compel your doctor to give you additional health screenings, prescribe certain drugs, and require additional follow-up appointments to monitor your weight. In this way your BMI is also tied to your healthcare costs.

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Why BMI Isn’t a Perfect Measure to Identify Overweight and Obese People

Despite its wide use, BMI is flawed. Increasingly, the scale has come under scrutiny as more and more people are being placed in its high-risk categories of overweight or obese. “Body mass index doesn’t show the difference between muscle and fat, so it doesn’t always accurately predict when weight could lead to health problems,” says Kim Larson, RDN, a health and wellness coach at Total Health in Woodinville, Washington.

BMI is not always the best measure of body fat and overall health, especially if you’re in any of the following groups:

<ul><li>Asian people The BMI scale is not a good measurement for individuals who are Asian, who may see increased health risks before their height and weight calculation qualifies as overweight (BMI of 25 or higher).<button><picture><img src="https://images.everydayhealth.com/react-component-images/right-up-arrow.svg?w=50"/> </picture> </button> As the American Heart Association points out, Asians are more likely to hold fat around their waistline, and this abdominal (called “visceral”) fat is especially dangerous.<button><picture><img src="https://images.everydayhealth.com/react-component-images/right-up-arrow.svg?w=50"/> </picture> </button> Because of this, doctors are encouraged to use a different BMI scale for Asians, with lower BMI cutoff points.<button><picture><img src="https://images.everydayhealth.com/react-component-images/right-up-arrow.svg?w=50"/> </picture> </button> </li><li>Athletes People who are extremely active have heavier bones and more lean mass (think muscle), resulting in higher body weights and higher BMIs, according to a previous study.<button><picture><img src="https://images.everydayhealth.com/react-component-images/right-up-arrow.svg?w=50"/> </picture> </button> But lean muscle mass can actually increase metabolism, as well as help ward off conditions like heart disease and type 2 diabetes, according to another study.<button><picture><img src="https://images.everydayhealth.com/react-component-images/right-up-arrow.svg?w=50"/> </picture> </button> Thus, an athlete with a high BMI may not necessarily be unhealthy. </li><li>Women who are pregnant or nursing Women typically have a higher body weight and body fat percentage when nursing or pregnant, per the CDC. This is so they can supply nourishment to the baby; it’s not an indication of long-term health risks.<button><picture><img src="https://images.everydayhealth.com/react-component-images/right-up-arrow.svg?w=50"/> </picture> </button> </li><li>Nonpregnant women Compared with men, women generally have a higher percentage of body fat, according to research.<button><picture><img src="https://images.everydayhealth.com/react-component-images/right-up-arrow.svg?w=50"/> </picture> </button> </li><li>People over age 65 A BMI of less than 23 in people older than 65 is associated with a higher health risk. And according to a previous meta-analysis, a BMI of 27 is the best in terms of decreased risk of mortality among this age group.<button><picture><img src="https://images.everydayhealth.com/react-component-images/right-up-arrow.svg?w=50"/> </picture> </button> The reason for this is not fully known, but most likely it’s multifactorial. Those with a higher BMI tend to carry more pounds of muscle compared with those with a lower BMI, which has a protective effect in terms of overall functionality, fall risk, and overall immunity. </li> </ul>

The agency also points out that BMI doesn’t measure excess body fat, which may be a better indicator of your health state. Think of it this way: When you step on the scale, the number recorded (which is used to calculate your BMI) doesn’t account for how your body weight is composed or where on your body it’s distributed.

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Is the BMI Scale Accurate Across Every Race and Background?

The BMI scale was developed by studying European men — does it apply to everyone else, specifically people in the Black, Indigenous, and People of Color (BIPOC) communities? Likely not.

“There is definite truth that the BMI was tested and validated in a white male population,” says <a href="https://www.hsph.harvard.edu/sara-bleich/">Sara Bleich, PhD </a>, a professor of public health policy at the Harvard T.H. Chan School of Public Health in Boston.

Yet Dr. Bleich explains that BMI is still useful as a tool because of the way it has evolved over time. “If BMI were only used in its original form and not changed, then we’d have to worry,” says Bleich. “There are so many different studies that have looked at elevated BMI risk in many different populations, and what it uniformly shows is that a higher BMI is bad for you. A major challenge is that, statistically, it’s normal in this country to be overweight, but each day when you’re walking around with excess weight, it’s increasing your risk for chronic conditions, and that’s true no matter [your race],” she says.

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That said, while BMI may have its flaws, obesity experts say that it is a useful tool. “Overall, the research shows that as a person’s BMI goes up, so, too, does their risk in all sorts of negative health outcomes, including type 2 diabetes, heart conditions, and hypertension,” says Bleich. “That’s compelling evidence that with increasing BMI, there are also increasing health risks.”

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Why Do Doctors Still Use BMI if There Are Flaws?

Kids’ body weight is measured using something called BMI percentile. Here’s how it works.

Most health professionals would agree that health risk should be measured by several factors. Among them are age, gender, medical history (including your health behaviors like exercise, sedentary time, nutrition, sleep, and stress), any abnormal blood laboratory tests, and family history.

It’s common for doctors and the general public to measure BMI, but the question, then, is this: Is there a better, more comprehensive approach to help paint a picture of your health using measurement tools? Here are some measurements that are commonly used alone or combined with BMI.

Larson prefers waist circumference and waist-to-hip ratio for health risk screening. “I think the best way to increase BMI accuracy is to add waist circumference and waist-to-hip ratio to the mix,” she says.

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The Takeaway on BMI and Measuring Body Weight

Bite-sized knowledge
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BMI Flaws, History, and Other Ways to Measure Body Weight and Fat | Everyday Health

What is BMI?

History of BMI

The BMI scale is innacurate

How innacurate is BMI?

Why do health-care providers still use BMI?

Why should there be alternatives to BMI?

Alternatives to BMI

Conclusion

IDEAS ABOUT

MORE LIKE THIS

BMI is Not Only Sufficient For Overall Fitness and Here's Why

Is BMI an Accurate Way to Measure Body Fat?

Top Facts About Obesity You Probably Didn't Know

It's time to

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LIKE

A PRO!

Bite-sized knowledgeto upgradeyour career

BMI Flaws, History, and Other Ways to Measure Body Weight and Fat | Everyday Health

What is BMI?

History of BMI

The BMI scale is innacurate

How innacurate is BMI?

Why do health-care providers still use BMI?

Why should there be alternatives to BMI?

Alternatives to BMI

Conclusion

IDEAS ABOUT

MORE LIKE THIS

BMI is Not Only Sufficient For Overall Fitness and Here's Why

Is BMI an Accurate Way to Measure Body Fat?

Top Facts About Obesity You Probably Didn't Know

It's time to

READ

LIKE

A PRO!

Bite-sized knowledge
to upgrade
your career