A recent study published in the journal PLOS One found that being overweight within the body mass index (BMI) range does not necessarily increase the risk of death. This study adds to the existing evidence indicating that BMI alone is not a reliable indicator of overall health.
The study analyzed data from over 550,000 adults in the United States over a nine-year period to investigate the relationship between BMI and the risk of death from any cause. The findings showed that individuals aged 65 and above with BMIs ranging from 22.5 to 34.9 did not have a significant increase in the risk of death.
Similarly, younger adults with BMIs between 22.5 and 27.4 also did not demonstrate a significant increase in mortality risk, as reported by NBC News. It is important to note that a BMI of 25 or higher is considered overweight, and a BMI of 30 or higher is classified as obesity.
What is a BMI?
For over a century, health professionals have used the body mass index (BMI) as a tool to assess whether individuals are underweight or overweight, according to Medical News Today. The recommended BMI range by experts usually falls between 18.5 and 24.99.
The concept of BMI was developed by Lambert Adolphe Jacques Quetelet, a Belgian astronomer, mathematician, statistician, and sociologist, in the 1830s. It involves a simple mathematical formula.
Despite its widespread use, BMI has some limitations, including its failure to account for the distribution of fat and lean tissue within the body, as reported.
How is BMI Calculated?
BMI is calculated by dividing an individual’s weight in kilograms (kg) by the square of their height in meters (m), aiming to estimate whether they have a healthy weight.
The current calculation for BMI is:
BMI = weight (kg) / height^2
Accepted criteria for BMI classifications worldwide typically include the following ranges:
- A BMI of 18.49 or below indicates underweight.
- A BMI between 18.5 and 24.99 suggests normal weight.
- A BMI between 25 and 29.99 indicates overweight.
- A BMI between 30 and 39.99 or higher signifies obesity.
- A BMI of 40 or above indicates morbid obesity.
These BMI ranges provide general guidelines to assess an individual’s weight status and potential health risks.
What Did the Study Say?
Healthcare professionals have long criticized the use of BMI, pointing out that it fails to consider factors such as body fat percentage and variations in disease risk based on race and gender, according to NBC News. The American Medical Association has recently recommended the use of additional measures, such as waist circumference, body fat distribution, and genetic factors, to assess a patient’s health.
The findings of the study support these new guidelines. Dr. Aayush Visaria, a co-author of the study, stated that their results confirm the limited predictive value of BMI as a standalone indicator of health risk. Waist circumference, however, showed a stronger association with overall mortality risk. Even among individuals with the same BMI, those with larger waist circumferences faced a higher risk of death.
The study did find that participants with a BMI of 30 or higher had a higher mortality risk. Younger adults with BMIs between 27.5 and 29.9 were also associated with a nearly 20% higher risk.
Dr. Fatima Stanford, an obesity medicine specialist, emphasized that BMI often equates leanness with health, disregarding other essential factors. She highlighted that substance abuse disorders, tobacco use, and disordered eating can lead to a lean physique without indicating good health.
Previous research has also shown the limitations of using BMI as the sole indicator of obesity or risk of weight-related diseases. Studies have demonstrated that a significant portion of individuals classified as overweight or obese by BMI are metabolically healthy, while a considerable percentage of those with “normal” weights exhibit metabolic health issues.
Any Limitations in the Study?
The new study acknowledged that previous research linking BMI and higher mortality primarily relied on data from the 1960s to 1990s, which mainly included white participants. However, the study sought to address this by including a diverse sample of participants, with a fairly representative composition.
Dr. Jaime Almandoz, who was not involved in the research, pointed out some limitations of the study. One limitation is that it focuses solely on the relationship between BMI and the risk of death, overlooking other health factors and conditions. Almandoz emphasized that life encompasses more than just mortality, and individuals with higher BMIs may still face health risks such as Type 2 diabetes, increased risk of heart attack, stroke, and heart failure.
According to the Centers for Disease Control and Prevention (CDC), individuals with BMIs of 25 or higher are at an increased risk of various health issues.
Almandoz also noted that the study underrepresents the proportion of individuals with obesity. While the study reported that about 27% of the participants had a BMI greater than 30, CDC surveys estimate that 42% of U.S. adults have obesity. The study’s co-author, Dr. Aayush Visaria, acknowledged that if the study had examined participants’ body fat percentages, the prevalence of obesity might have been higher than indicated by BMI alone, highlighting the limitation of BMI in accurately measuring body fat.
Visaria suggested that clinicians should consider using alternative measures of body fat to diagnose obesity, rather than relying solely on BMI. He believes that in the future, such measures will become more commonplace in clinical practice.
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