Body Mass Index, or commonly known as BMI, is a standard health assessment tool used in many healthcare facilities over many decades. It is often used as a health indicator to assess for overweight and obesity, using an individual’s weight relative to height. The results will then be compared to the BMI scale to determine the results, classification of “underweight”, “normal weight” or “overweight”. Many studies also support that BMI can be a pre-assessment tool of a person’s risk of chronic disease and premature death, especially amongst people who have obesity or “overweight” and “underweight”. 

While BMI is a widely used tool due to its simplicity and convenience, its accuracy and limitations should also be considered when interpreting the results as it only uses weight and height of an individual to measure, which may lead to inaccurate outcomes.

Here are some limitations of BMI:

Distinguish between Fat Mass and Muscle Mass: Muscles are usually denser and takes up less space, which can lead to misinterpretation of results. For example, an athlete or an individual with low body fat and high amount of muscle mass will be classified to be heavier or “overweight” using the BMI scale, leading to misinterpretation of their health status. Therefore, it is important to consider an individual’s body composition in addition to their bodyweight. 

Body Fat Distribution: BMI does not differentiate between subcutaneous fats and visceral fats. Visceral fats are found within our internal abdominal cavity, surrounding our internal organs and by have high amounts of it is often strongly associated with health risks such as cardiovascular diseases. As compared to subcutaneous fats that are stored in other parts of the body such as the hips and buttocks region. Since BMI does not consider what type and where the fats are stored, it can misclassify an individual’s health indication or risk of disease.

Other health assessments to consider:

Body Fat Percentage: Determining an individual’s amount of body fat in the body. It can distinguish an individual’s fat mass vs fat-free mass, which will be a more accurate representation of health indication. Assessment tools such as skinfold measurements, bioelectrical impedance analysers or dual-energy x-ray absorptiometry can be used to analyse. 

Waist-to-Hip Ratio: Measuring an individual’s waist and hip using a formula and determining the ratio against a measurement chart. A higher ratio will mean that there is a high amount of fats store in the belly region which is linked to a greater risk of developing chronic diseases.

Despite these limitations, BMI is still useful for assessing potential health risk relating to an individual’s bodyweight at a general population level due to its convenience and simplicity. However, it is recommended to interpret the results in-view with other health assessment measures to get the most accurate results. 

References:

Flegal, K. M., Shepherd, J. A., Looker, A. C., Graubard, B. I., Borrud, L. G., & Ogden, C. L. (2009). Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. American Journal of Clinical Nutrition, 89(2), 500-508.

https://pubmed.ncbi.nlm.nih.gov/19116329

Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., & Lisheng, L. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. The Lancet, 364(9438), 937-952.

https://pubmed.ncbi.nlm.nih.gov/15364185

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