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THE Rumor: You can have a normal BMI but still be overweight
If you’re striving to maintain a healthy weight or your doctor tells you to lose a few pounds, you might think it’s wise to have a body mass index (BMI)number that puts you in the “normal” range -- especially since researchers recently found that there's a direct link between high BMIs and heart failure. But what if your BMI number seems unrealistic for your body type and height? Does that mean you’re considered overweight or obese? And if you do fall in the normal range, does that mean you’re “healthy”?
The Verdict: The BMI chart has limits
According to the Centers for Disease Control and Prevention, a BMI of 24 or lower means your weight is normal, 25 to 29 means you’re overweight and 30 or higher means you’re obese. “The BMI number is generally used as a screening tool,” says Dr. Derrick Cetin, DO, a Cleveland Clinic obesity specialist. “It’s a measure of the body shape and is a predictor of body fat, mortality and morbidity.”
And yet, the BMI calculator has its limits. For one thing, you can lose fat and gain lean muscle, and your BMI number will stay the same because the chart only accounts for height and weight. Likewise, it could place a bodybuilder in the obese category due to his or her weight, even if said weight primarily consisted of lean muscle, not fat. And it could place an older person with a lot of body fat in the normal category, simply because he or she has a seemingly healthy weight. No matter what your age, if your body weight is normal yet you have a high percentage of body fat, you might be “normal-weight obese.”
Let’s say you’re a 30-year-old, 6’ tall person who falls into the 25 to 29 “overweight” category of the BMI chart. “That patient might think I [as their doctor] want them at a weight of 160 pounds [even if] they’re currently at a weight of 250,” says Dr. Cetin. “That’s unrealistic. I’m not asking them to get to a weight that’s in the ‘normal range’ of the BMI chart. I’m asking them to get to a healthy weight and to lose 10 percent of their body weight. Many obese patients I see... think they have to get to a normal BMI range, but that’s not realistic for most.”
At the Cleveland Clinic, patients with BMI’s over 30 are often told to lose a few BMI points. It usually translates to about five pounds per BMI point, says Dr. Cetin. “But people don’t even know what a BMI is in the first place,” he says. “I get them to understand that when their BMI is high, they are at risk. Mortality and morbidity risks go up. I’ll tell them I want them to lose 10 percent of their body weight in six months -- and most people can do that.”
Losing 10 percent of your body weight has been proven to have significant health benefits. According to Dr. Cetin, it can lower your risk for diabetes, improve blood pressure and cholesterol numbers and help with sleep apnea, to name just a few. “You’re looking for a weight loss that helps make improvements on the underlying health conditions you have,” he says.
As for total body fat, you want it to stay under 25 percent for women and under 30 percent for men. But the numbers are age-specific: Ideally, 28- to 40-year-old women would have 21 to 33 percent body fat, while men in that age range would have around 19 percent. (Men naturally carry more muscle mass, but we all lose some as we age, according to Dr. Cetin.)
Measuring waist circumference helps screen for possible health risks that come with being overweight or obese. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes, according to the National Institutes of Health. Having a waist size that’s greater than 35 inches for women or 40 inches for men increases that risk. To correctly measure your waist, stand and place a tape measure around your middle, just above your hipbones. Take the measurement just after you breathe out, and log the number. Track your waist measurements weekly after you hop off the scale, and you’ll have a well-rounded perspective on your weight.
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