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Why Doctors are Moving Beyond BMI
Why BMI Falls Short
BMI is such a popular metric because it is straightforward and easy to calculate. However, it doesn’t always paint the full picture as it doesn’t distinguish between fat and muscle and doesn’t account for where that fat is located on the body. As you’ve probably heard – muscle weighs more than fat, which means two people can have the same BMI but vastly different health profiles. Take for instance a muscular athlete and someone with excess abdominal fat of similar heights. Both could weigh 250 pounds and therefore have the same BMI, but the athlete would be healthier in most ways. More critically, BMI treats visceral fat, the harmful fat stored around internal organs, which is strongly linked to cardiovascular disease, diabetes, and certain cancers, the same as other kinds of fat when that is just not the case.
Waist Circumference and Waist-to-Height Ratio
With BMI being a useful but limited tool, health care providers have developed other ways to measure body health. One of those additional metrics, waist circumference (WC) offers insight into abdominal fat levels. This is a better estimate of visceral fat and of metabolic and cardiovascular risk. By measuring the waist around the abdomen, (typically just above the belly button), clinicians can assess whether a person is at risk regardless of their overall weight.
Going a step further, the waist-to-height ratio (WHtR) compares waist size to a person’s height. This is a simple way to assess body fat distribution across individuals of different body types. The general guideline is simple: keep your waist circumference less than half your height. For example, someone who is 70 inches tall (5’10”) should aim for a waist under 35 inches. (This is a general guideline and should not be strictly adhered to for children, the elderly, or those with certain health concerns.)
Doctors Are Shifting Focus Away From BMI
An analysis of 34 studies, reviewing more than 500,000 participants, showed that WHtR is a better predictor of heart disease, diabetes, and mortality risk than BMI.1 It’s particularly useful for identifying health risks in people who fall into the “normal weight” BMI category but carry excess abdominal fat. As a result, health professionals are increasingly using waist measurements alongside or instead of BMI to guide lifestyle advice and interventions.
While BMI remains a useful screening tool, it shouldn’t be the only measure of health. Waist circumference and the waist-to-height ratio provide a clearer view of body fat distribution and its associated health risks. Keeping your waist under half your height may be a more reliable but still simple way to monitor your health — and a goal worth measuring.
CONTRIBUTING EXPERT
Chandar Abboy, MD
Dr. Abboy is a physician board-certified in internal medicine, pulmonary disease, critical care medicine, and sleep medicine. He is a Principal Investigator at Care Access, overseeing multiple clinical trials.
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The information provided on Care Access is intended for informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Our products and content are not intended to diagnose, treat, cure, or prevent any disease.
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