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Is BMI a good indicator of a healthy weight?

Hi guys, we’re about to share with you the opinion from five experts of different fields to answer an interesting question: Is BMI a good indicator of a healthy weight? Or is it a formula from the past that should come back to there?


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First of all, according to Robert H. Shmerling, MD (Senior Faculty Editor, Harvard Health Publishing) BMI is a calculation of your size that takes into account your height and weight. A normal BMI is between 18.5 and 25; a person with a BMI between 25 and 30 is considered overweight, and a person with a BMI over 30 is considered obese, and also a person is considered underweight if hers/his number is less than 18.5. Although its origin is over 200 years old, it is fairly new as a measure of health.

As with most measures of health, BMI is not a perfect test. For example, results can be thrown off by pregnancy or high muscle mass, and it may not be a good measure of health for children or the elderly.

According to an article which you can find at “Scientific American” the BMI is an unperfect kind of measurement. We can begin with a common fact that it doesn't distinguish between body fat and muscle mass, which is important because a hunk of muscle weighs more than the same size hunk of fat.

Some good examples of this misinterpretation, according to an analysis of BMI’s Blind Spots, are former Olympians Usain Bolt and Michael Phelps, who just narrowly miss the 'overweight' camp. Then there is star NFL quarterback Tom Brady who’s BMI categorizes him as obese. Also, basketball player Lebron James and NHL right-winger, Phil Kessel, both have a BMI of 27.5 and as we will learn later, a BMI between 25-29.9 is considered overweight.

The experts’ answers are the following:

Alessandro Demaio (MD) says that: “There are two questions here – whether BMI is a good indicator of weight, and whether weight is an accurate reflection of health. BMI, the tool most often used to determine “healthy weight ranges”, was designed primarily to track the weight of populations. While it’s a simple and useful screening tool when looking at groups of people, it’s not an accurate marker of individual health. This is because BMI is a measure of our height and our weight, and the ratios of their combination. But weight alone doesn’t discriminate between a kilogram of fat versus a kilogram of muscle, nor does it account for body shape and fat distribution differences relating to, say, ethnicity or gender.
Then, just as not all overweight individuals have heart disease risk factors or unhealthy metabolisms (the conversion of food into energy), not all lean people have healthy ones. As a rough rule of thumb, both BMI and weight are still helpful for estimating healthiness – particularly when combined with a measurement of waist circumference – and excess weight or significant weight gain are associated with a range of disease outcomes. But BMI or weight alone do not replace the need for a proper checkup with your GP, nor do they provide a guarantee of well-being.”

Emma Gearon (Epidemiologist): BMI is a simple indicator of weight for height and can't differentiate between muscle mass and fat mass. So, BMI tends to overestimate the health risk for adults with a high muscle mass, such as some athletes, and underestimate the risk for adults with a low muscle mass, as can occur with sedentary lifestyles. Despite this limitation, BMI is generally thought to adequately identify risk across the whole population.

But we have recently found BMI is increasingly underestimating the level of risk in the Australian population compared to waist circumference. In the 2011-12 health survey, 10% of women classified as normal weight by BMI, and 50% of women and 25% of men classified as overweight by BMI were obese according to their waist circumference. Consequently, BMI underestimated the prevalence of obesity by almost 50% for women and 30% for men. BMI can no longer be considered a reliable indicator of healthy weight, and further research is needed to identify a suitable alternative.

Evelyn Parr (Exercise Scientist): Indicators of strength, fitness, and central fat tissue are far more indicative of health than BMI. BMI does not tell us how much muscle someone has, or where their body fat is distributed such as the arms and legs vs around the middle. BMI indicates one’s weight when taking into consideration how tall they are. As such, BMI is a great measure for large studies or the time-poor doctor’s office.

Many studies, normally with thousands of participants, use BMI as a mortality predictor. As individuals, our focus should be on our fitness, as it’s our muscle that helps us stay healthy while we age. If we don’t maintain muscle, we face a generation of people with low muscle mass and too much fat. Let’s look at more important measures of fitness to indicate how healthy an individual is – irrespective of their body weight, and keep BMI for the large studies.

Steve Stannard (Nutrition & Sport): For an individual, BMI alone is not a good indicator of whether someone is a healthy body weight. The body mass index roughly describes a person’s shape; a higher BMI representing someone with a large volume to surface area (wide for their height, ball-shaped), while a low BMI describes the opposite (thin for their height, stick-shaped). Most often, someone who is wide is probably so because they carry a lot of body fat, but not always. Sometimes they are just short and muscular, and plenty of fit muscle is healthy!

However, at a population level, we do know that on average a person with a high BMI has a greater chance of suffering from many non-communicable diseases, including diabetes and heart disease, which are associated with carrying too much body fat. BMI would be better described as a good indicator of the health of a population.

Tim Crowe (Dietician): BMI only gives a very approximate guide to health-related to weight and height and gives no information on body fat content or location. BMI ranges can also vary depending on ethnicity. It is also now acknowledged that as we enter into older age, a higher BMI is linked to improved nutritional status, protection against falls, and lower disease risk.

Simple measurements such as waist circumference are more useful for an individual as they look directly at body fat around the abdomen which is more directly related to disease risk. BMI is much better for looking at the health of whole populations and how this change over time rather then as a diagnostic tool for an individual.

Is your weight good for now? Check with our BMI calculator clicking here.


References:

https://theconversation.com/is-bmi-a-good-way-to-tell-if-my-weight-is-healthy-we-asked-five-experts-96985#:~:text=BMI%20is%20a%20simple%20indicator,can%20occur%20with%20sedentary%20lifestyles.

https://www.health.harvard.edu/blog/how-useful-is-the-body-mass-index-bmi-201603309339

https://www.scientificamerican.com/article/is-bmi-an-accurate-way-to-measure-body-fat/

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