Body mass index (BMI) alone doesn’t tell the whole story of your health. While traditionally used as a critical health metric, medical professionals now emphasize that true health assessment requires looking at multiple factors beyond weight and height calculations.
Recently, I had the opportunity to be interviewed by Verywell Health, where I discussed the importance of reviewing a patient’s metabolic health, mental health, risk factors, and family history instead of simply reviewing their BMI and weight.
A growing number of patients and healthcare providers are embracing the idea that a higher number on the scale doesn’t automatically equal poor health. Movements like Health at Every Size promote a holistic definition of health, focusing on individual wellness rather than standardized metrics, according to the Association for Size Diversity and Health.
However, this concept raises the question: If body mass index (BMI) and other weight-related metrics don’t define health, what does? What do physicians look for in a general exam when someone is not explicitly interested in losing weight?
Why BMI doesn’t tell the whole story
BMI is calculated by dividing a person’s weight by the square of their height. In recent years, experts have criticized BMI for not accounting for several factors that impact health.
“While we know that the amount of body fat correlates with the risk of obesity-related conditions like diabetes, hypertension, fatty liver disease, heart disease, and others, weight and BMI are imperfect reflections of the level of body fat mass,” Richard Gitomer, MD, associate medical director for primary care at MDLIVE, told Verywell. “Body fat mass can be impacted by age, gender, race, volume status, and muscularity.”
The mathematical equation for BMI doesn’t account for body composition. An elite weightlifter may be considered obese by this standard since the equation treats muscle mass the same as fat mass.
The Centers for Disease Control and Prevention (CDC) says that BMI is most often used because it’s inexpensive and accessible, making it the default metric for many providers.
“However, a more comprehensive approach offers a more accurate view of individual health,” Gitomer said.
“A more holistic approach to patient health assessment, recognizing the shortcomings of weight or BMI accounting for the factors above and incorporating a variety of additional factors, offers a better reflection of a person’s health,” he said. “Given the complexity of health, our approach to assessment must be equally nuanced.”
More specific criteria paint a more accurate picture
Thais Aliabadi, MD, OBGYN, founder of the weight management program Trimly, said she reviews a patient’s metabolic health, mental health, risk factors, and family history instead of simply evaluating their BMI and weight.
“Elevated blood pressure, cholesterol levels, and blood sugar levels may indicate underlying health issues, even in patients with a normal BMI,” she told Verywell.
“This approach provides a more nuanced understanding of how the body processes energy and responds to different dietary and lifestyle factors. Of course, a patient’s individual dietary habits and physical fitness help me identify areas for improvement irrespective of BMI.”
Normal ranges providers look for in adults
Blood pressure
A normal blood pressure is less than 120/80 mm Hg.
Cholesterol
Healthy cholesterol levels include:
- Total cholesterol: 125 mg/dL to 200 mg/dL
- Triglycerides: less than 150 mg/dL
- HDL: 40 mg/dL or higher in men, 50 mg/dL or higher in women
- LDL: less than 100 mg/dL
- Non-HDL: less than 130 mg/dL
Blood sugar
The normal range for fasting blood glucose (blood glucose when you haven’t eaten) is between 70 mg/dL and 100 mg/dL.
Gitomer said healthy ranges for metrics like blood pressure and blood sugar aren’t the same for everyone.
“For example, for elderly adults, we might target a higher blood sugar value to reduce the risk of low blood sugar,” he said. “Blood pressure targets are impacted by the presence of diabetes, cardiovascular, and kidney disease, while cholesterol targets are impacted by cardiovascular risk and history of stroke or heart attack.”
Gitomer also takes age, sex, and lifestyle factors into consideration.
“Lifestyle factors, including physical activity levels, dietary habits or restrictions, sleep quality, and stress management further impact the biological factors,” he said. “Regular physical activity and a balanced diet, for example, can mitigate the risk of chronic diseases, improve mental health, and enhance quality of life, irrespective of weight or BMI.”
“People with chronic diseases, in particular, shouldn’t place too much importance on BMI”, Gitomer added.
“Patients with inflammatory bowel disease, for instance, may experience fluctuations in weight due to their illness or the medications used for treatment,” Gitomer said. “Despite being classified as ‘overweight’ by standard BMI measures, many of these patients maintain good health through effective disease management, highlighting the limitations of using weight as a sole health indicator.”
What this means for you
BMI and weight may be accessible metrics for health, but they should not be considered all-encompassing. If your doctor looks for markers of disease such as diabetes, high blood pressure, or metabolic syndrome, especially when paired with an honest analysis of your lifestyle and diet, you’ll get a more complete picture of your health.
Rachel Murphy began her career in the arts industry, covering the performing arts in Kansas City. She covers health and wellness for In Kansas City Magazine, VerywellHealth.com, PrimeWomen.com, and many others. She also served as Managing Editor of Northland Lifestyle for 10 years.
She has a lifelong love of beauty and wellness topics, from skincare to yoga to nutrition. At the same time, she makes difficult health topics easier to understand, like dementia innovations and medication studies.
Rachel served as the dining and cocktail writer for Kansas City Spaces Magazine for four years. She shares her home with her photographer/husband and two toddler girls.
Read the whole article at Verywell Health.
Take control of your health: contact Dr. Aliabadi
Dr. Aliabadi and her friendly, professional team provide top-in-the-industry care to patients at all stages of life. As a leading expert in medically supervised weight management, Dr. Aliabadi offers comprehensive care, including expertise in weight management drugs and addressing medically related weight gain. Our programs prioritize patients’ safety and well-being, ensuring they receive the best possible care.
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