Body Mass Index (BMI): Can We Trust It?

Body Mass Index (BMI) is a primary tool used both by physicians to track healthy body weight, and by individuals tracking their fitness progress.

It differs from body fat percentage in that it takes overall body size into account, not just fat. Even so, it’s considered an accurate estimation of healthy weight and predictor of obesity-related diseases by the National Heart, Lung and Blood Institute and the Centers for Disease Control among other health authorities.[1,2]

The Basics Of BMI

The big appeal of BMI is that it’s about as simple and inexpensive as a health monitoring method can get, yet it’s been shown to be fairly accurate in predicting the development of metabolic risk factors like high blood pressure, elevated fasting glucose and unbalanced cholesterol levels.[3]

All you need to do to measure it is get an accurate reading of your current height and weight. So it’s virtually cost-free for a physician and it’s relatively inexpensive and easy for someone to monitor on their own.

First you take your weight (in pounds), then multiply it by 703. You then multiply your total height in inches by itself, and divide the first total by the second. For metric system users, there’s less multiplication — just divide your weight in kilograms by your height in meters times itself.

The target range for a healthy weight is 18.5 to 24.9. 25 to 29.9 is seen as “overweight”, and 30 and up is where the at-risk “obese” classifications start. “Morbid obesity”, where serious obesity-related health problems are expected to occur, starts at a BMI of 40.

But How Accurate Can Something That Simple Be?

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Although BMI is considered accurate enough to be a medical standard, it does have a fair amount of false positives.

One problem you might think of right away is bodybuilders. Big weightlifters who have tons of lean mass seem like an obvious target for misclassification under this system. However, you might be surprised to learn that they actually rarely get misclassified as obese, at least according to medical studies. For example, two fairly recent studies that used a population of mostly fit career firefighters found only about 5% of muscular firefighters misclassified in this way in the first study and about 9% in the second.[4,5]

The misclassification problems are instead centered on people who are actually obese not being categorized properly. Studies frequently have a significant number of these misclassifications, approaching almost half of the participants in some studies![6]

Mistaken self-reporting of weight and height is one cause of these misclassifications. But they remain significant even when conducted by a medical professional. The main reason is that people who are technically obese also often have very low levels of lean mass — muscle, water and glycogen — so their total body mass appears to be at a healthier level than it actually is.

BMI Plus

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What these studies show is that while BMI is useful, it does have its limitations. It’s excellent when paired with other common measurements of obesity, however, namely body fat percentage and waist circumference.

If you can’t visibly see any muscle tone — and be honest with yourself — then there’s room for improvement.

The one major thing to watch out for with it is overconfidence in your fitness and health if you’re on the borderline of at-risk obesity levels. If it’s the only method that you’re using to track your weight and you’re not doing resistance training to build muscle, you could be getting a very inaccurate picture of where your body composition is at.

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