Obesity is an epidemic of sorts across the rich world as well as in developing countries. With increasing awareness of weight related health issues, people including medical professionals have widely used the Body Mass Index or BMI to determine if they are overweight or not. However, recent findings show that whilst BMI does a good job in indicating obesity at the population level, it is not necessarily the right measure at the individual level given various other factors that can contribute to weight which tend to cancel out at the population level.
“Body mass index is a measurement taken by dividing body weight in kilogrammes by height in metres squared. The metric was developed to estimate a normal body weight depending on an individual’s height, given that taller people tend to weigh more.
It rose to prominence for clinicians in the 1990s following the World Health Organization’s adoption of the metric as the official screening index for obesity.
Research has consistently shown that BMI at a population level correlates strongly with body fat percentage and risk for serious health conditions. The index is easy to measure and inexpensive to calculate, allowing its wide implementation in health care settings.”
However, it has its own limitations at the individual level:
“…people with the same BMI may have substantially different body fat percentage based on a variety of factors such as age, muscle mass, sex and race. In an example from one large study, adults with a BMI of 25 had a body fat percentage ranging from 14% to 35% for men, and 26% to 42% for women.
Ultimately, BMI cannot provide doctors with precise information about the portion of body weight comprised of body fat, nor can it tell us how that fat is distributed in the body. But this distribution is important because research has shown that fat stored around the internal organs has significantly higher health risks than that distributed in the extremities.
Further, just as a variety of health factors may affect the accuracy of BMI to predict how much body fat someone has, health outcomes such as developing diabetes at a specific BMI can vary substantially based on factors such as a person’s race, sex, age and physical fitness level.
Finally, a significant number of adults may have metabolically healthy obesity, defined as having a BMI above 30 without having high blood pressure, blood sugar or cholesterol. Adults with metabolically healthy obesity have significantly lower health risks associated with a high BMI and therefore may not benefit from weight loss.
Although research in the 1970s suggested that any BMI above a normal (18.5-24.9) range shortened life expectancy, some modern studies suggest that BMI in the overweight (25-29.9) to class 1 obesity (30-34.9) range does not raise risk for early death.
The potentially lower risk of death in modern studies for people with higher body weight might be explained by improved treatment of conditions such as high cholesterol and blood pressure, common contributors to shortened life expectancy for people with a BMI over 30.”
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