Body Mass Index: How Accurate is BMI? (cont.)
According to the NIH definitions, a healthy weight is a BMI of 18.5-24.9; overweight is 25-29.9; and obese is 30 or higher.
The Measurement of Choice
BMI is the measurement of choice for most health professionals.
"I think BMI is a very good and easy screening tool," says obesity expert, Cathy Nonas, MS, RD, a spokeswoman for the American Dietetic Association.
But while it is a simple, inexpensive method of screening for weight categories, it is not a diagnostic tool. Health professionals need to do further assessments to fully evaluate health risks. These assessments would include measurements of body fat percentage, diet history, exercise patterns, and family history.
Further, BMI does not take into account age, gender, or muscle mass. Nor does it distinguish between lean body mass and fat mass. As a result, some people, such as heavily muscled athletes, may have a high BMI even though they don't have a high percentage of body fat. In others, such as elderly people, BMI may appear normal even though muscle has been lost with aging.
Take for example, basketball player Michael Jordan: ''When he was in his prime, his BMI was 27-29, classifying him as overweight, yet his waist size was less than 30,'' says Michael Roizen, MD.
That's one reason some experts think waist circumference can be a better overall health measurement than BMI.
Another is that your health is not only affected by excess body fat, but also by where the fat is located. Some people gain weight in their abdominal regions (the so-called ''apple'' body shape.) Others are ''pear-shaped,'' with excess weight around the hips and buttocks. People with apple shapes are at higher risk for health problems associated with being overweight.
"Fat around your waist is more biologically active and can do more damage to your body than weight around your hips," says Roizen, co-author of You: On a Diet. "The data show that waist circumference is more reliable and more closely correlated with diseases associated with obesity."
According to the National Institutes of Health, a bigger waist circumference (greater than 40 inches for men and 35 inches for women) is linked to a higher risk of type 2 diabetes, high blood pressure, abnormal cholesterol levels, and heart disease when BMI is 25 to 34.9.
To properly measure your waist, no math is needed. Just use a soft tape measure around your bare midsection at your belly button. Find your upper hip bone, and measure around the abdomen above the bone. The tape should be snug, but not dig into your skin.
Nonas argues that waist circumference is not a better tool than the BMI "because we do not have good criteria or cut points for levels of overweight, obesity, age or height." She also thinks that properly measuring the waistline is a little more difficult than measuring height and weight.