People who are obese (BMI of 30 or above) almost always have a large amount of body fat in relation to their height. People who are overweight (BMI of 25–29.9) have too much body weight for their height. This ratio of weight to height is known as the body mass index (BMI). For adults, a healthy weight is defined as the appropriate body weight in relation to height. ‘But for the man in the street to get an early health warning signal, waist-to-height and a piece of string is more effective.BMI is an estimate of body fat and a good measure of your patients' risk for diseases that can occur with overweight and obesity. ‘BMI does have its uses – because it’s used everywhere it has helped us build continuity in our data. ‘If you want a scientific message to be accepted as public health policy it needs to be simple. ‘They’ve managed to get the process down to something that doesn’t need a tape measure, scales or equipment so it can be done anywhere around the world’ says Dr Ashwell. You measure a person’s height using a piece of string then cut or fold it in half and put it around their waist and it should fit. Thailand also has a government policy which measures people’s waist to height ratio and even uses a piece of string to do it. There are some places around the world further ahead in getting it into policy such as New Zealand, who use it in their survey data. My mum wants me to wear a family heirloom wedding dress - but it's horrible Read More Stories It’s an early warning sign that you are storing your fat around your middle, which can lead to a variety of health problems in the future, something the BMI often discounts. Health risks start when your waist measurement is more than half your height. It’s also accurate for children as well as adults of any gender. Waist-to-height ratio works well regardless of race. This recommendation is backed by a 2017 study by Leeds Beckett University. Dr Ashwell promotes the use of waist-to-height ratio as the most accurate measure of obesity. Guidelines from the National Heart, Lung and Blood Institute recommended looking at waist circumference.īut even this isn’t entirely accurate when used in isolation. In regard to body fat, there are other measurements recommended for assessing the risk of obesity-related diseases. ‘I haven’t done that but I have been saying the same thing for twenty odd years and the more I say it, the more evidence there is to support it,’ she adds. ‘It needs to be put into policy and if I had devoted my whole life to political lobbying on this issue, perhaps something might have changed. ‘It’s very hard to change something that’s so set in stone,’ says Dr Margaret Ashwell, President of the Association for Nutrition. So if BMI is so problematic, why is it still so widely used? The National Institute For Health and Care Excellence is currently reviewing its use. It further theorises that the weight gap between white and black women may have to do with how body fat is distributed differently throughout the body.Įven if you take the issue of race out of the equation, BMI is still a woefully inadequate and inaccurate measure of obesity and, as a result, health. New research suggests that higher muscle mass is not just an issue for athletes.Ī 2011 study published in the research journal Obesity found that while white women with a BMI of 30 or more and a waist circumference of 36 inches or more were at greater risk for diabetes, high blood pressure and high cholesterol, black women with those same numbers were considered medically healthy. The BMI also does not distinguish between body fat and muscle mass, which is why muscular athletes can have a high BMI, particularly as muscle is heavier than fat. It would seem the answer may just be yes.īMI has its limitations because it does not take into account differing body shapes that are not a result of excess body fat. So I began to wonder, are black women being unfairly penalised by an outdated measure that potentially discriminates along the lines of race? It’s even used to determine if you are eligible for some medical procedures such as IVF and surgery. In addition to insurance companies, certain professions also use it to determine a candidate’s eligibility. It is often used to measure the risk of developing type 2 diabetes, as well as other metabolic diseases such as hypertension, high cholesterol and heart disease.īecause of this, it has become the de facto measure of how healthy a person is. This is a potential issue because BMI is used by the medical profession to quickly determine a person’s weight in relation to their height.
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