Body Mass Index is a mystery to most people. Did you know that Black Americans have less body fat than do Whites¹, and Asians have more body fat than do Whites. Jay Harold wrote this post, “5 Reasons Why Body Mass Index is Important to Black Americans,”  to determine what BMI is and why it’s important to your health.

Here’s some facts about BMI

At the same BMI,

1. Hispanics (47.0%) and non-Hispanic blacks (46.8%) had the highest age-adjusted prevalence of obesity, followed by non-Hispanic whites (37.9%) and non-Hispanic Asians (12.7%).
2. The prevalence of obesity was 35.7% among young adults age 20–39 years, 42.8% among middle-aged adults age 40-59 years, and 41.0% among older adults age 60 and over.
3. The prevalence of obesity was 39.8% and affected about 93.3 million U.S. adults in 2015-2016.
4. Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death.
5. The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight.

What is BMI?

BMI² is a person’s weight in kilograms divided by the square of height in meters. BMI does not measure body fat directly, but research has shown that BMI is moderately correlated with more direct measures of body fat obtained from skinfold thickness measurements, bioelectrical impedance, densitometry (underwater weighing), dual energy x-ray absorptiometry (DXA) and other methods ^1,2,3. Furthermore, BMI appears to be as strongly correlated with various metabolic and disease outcome as are these more direct measures of body fatness ^4,5,6,7,8,9. In general, BMI is an inexpensive and easy-to-perform method of screening for weight category, for example underweight, normal or healthy weight, overweight, and obesity.

How is BMI used?

A high BMI can be an indicator of high body fatness. BMI can be used as a screening tool but is not diagnostic of the body fatness or health of an individual.

To determine if a high BMI is a health risk, a healthcare provider would need to perform further assessments. These assessments might include skinfold thickness measurements, evaluations of diet, physical activity, family history, and other appropriate health screenings¹⁰.

What are the BMI trends for adults in the United States?

The prevalence of adult BMI greater than or equal to 30 kg/m² (obese status) has greatly increased since the 1970s. Recently, however, this trend has leveled off, except for older women. Obesity has continued to increase in adult women who are age 60 years and older.

Why is BMI used to measure overweight and obesity?

BMI can be used for population assessment of overweight and obesity. Because calculation requires only height and weight, it is inexpensive and easy to use for clinicians and for the general public. BMI can be used as a screening tool for body fatness but is not diagnostic.

What are some of the other ways to assess excess body fatness besides BMI?

Other methods to measure body fatness include skinfold thickness measurements (with calipers), underwater weighing, bioelectrical impedance, dual-energy x-ray absorptiometry (DXA), and isotope dilution ^1,2,3. However, these methods are not always readily available, and they are either expensive or need to be conducted by highly trained personnel. Furthermore, many of these methods can be difficult to standardize across observers or machines, complicating comparisons across studies and time periods.

How is BMI interpreted for adults?

For adults 20 years old and older, BMI is interpreted using standard weight status categories. These categories are the same for men and women of all body types and ages.

The standard weight status categories associated with BMI ranges for adults are shown in the following table.

For example, here are the weight ranges, the corresponding BMI ranges, and the weight status categories for a person who is 5′ 9″.

Is BMI interpreted the same way for children and teens as it is for adults?

BMI is interpreted differently for children and teens³, even though it is calculated using the same formula as adult BMI. Children and teen’s BMI need to be age and sex-specific because the amount of body fat changes with age and the amount of body fat differs between girls and boys. The CDC BMI-for-age growth charts take into account these differences and visually show BMI as a percentile ranking. These percentiles were determined using representative data of the U.S. population of 2- to 19-year-olds that were collected in various surveys from 1963-65 to 1988-94.

Obesity among 2- to 19-year-olds is defined as a BMI at or above the 95^th percentile of children of the same age and sex in this 1963 to 1994 reference population. For example, a 10-year-old boy of average height (56 inches) who weighs 102 pounds would have a BMI of 22.9 kg/m². This would place the boy in the 95^th percentile for BMI – meaning that his BMI is greater than that of 95% of similarly aged boys in this reference population – and he would be considered to have obesity.

How good is BMI as an indicator of body fatness?

The correlation between the BMI and body fatness is fairly strong, but even if 2 people have the same BMI, their level of body fatness may differ.

In general,

• At the same BMI, women tend to have more body fat than men.
• At the same BMI, Blacks have less body fat than do Whites, and Asians have more body fat than do Whites
• At the same BMI, older people, on average, tend to have more body fat than younger adults.
• At the same BMI, athletes have less body fat than do non-athletes.

The accuracy of BMI as an indicator of body fatness also appears to be higher in persons with higher levels of BMI and body fatness¹⁶. While, a person with a very high BMI (e.g., 35 kg/m²) is very likely to have high body fat, a relatively high BMI can be the results of either high body fat or high lean body mass (muscle and bone). A trained healthcare provider should perform appropriate health assessments in order to evaluate an individual’s health status and risks.

If an athlete or another person with a lot of muscle has a BMI over 25, is that person still considered to be overweight?

According to the BMI weight status categories, anyone with a BMI between 25 and 29.9 would be classified as overweight, and anyone with a BMI over 30 would be classified as obese.

However, athletes may have a high BMI because of increased muscularity rather than increased body fatness. In general, a person who has a high BMI is likely to have body fatness and would be considered to be overweight or obese, but this may not apply to athletes. A trained healthcare provider should perform appropriate health assessments in order to evaluate an individual’s health status and risks.

14 Health consequences of obesity for adults²?

People who have obesity are at increased risk for many diseases and health conditions, including the following:

1. All-causes of death (mortality)
2. High blood pressure (Hypertension)
3. High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (Dyslipidemia)
4. Type 2 diabetes
5. Coronary heart disease
6. Stroke
7. Gallbladder disease
8. Osteoarthritis (a breakdown of cartilage and bone within a joint)
9. Sleep apnea and breathing problems
10. Chronic inflammation and increased oxidative stress
11. Some cancers (endometrial, breast, colon, kidney, gallbladder, and liver)
12. Low quality of life
13. Mental illness such as clinical depression, anxiety, and other mental disorders
14. Body pain and difficulty with physical functioning

Heart Disease, diabetes, and strokes^4,5 are leading causes of death among male and female Black Americans in 2015. BMI is an inexpensive and easy-to-perform method of screening to reduce your risk.

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1. https://www.cdc.gov/obesity/data/adult.html
2. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
3. https://www.cdc.gov/growthcharts/clinical_charts.htm
4. https://www.cdc.gov/women/lcod/2015/race-ethnicity/index.htm
5. https://www.cdc.gov/healthequity/lcod/men/2015/race-ethnicity/index.htm