BMI: what the number means, what it misses, and why it still matters
Body Mass Index was invented in the 1830s by Belgian statistician Adolphe Quetelet — not as a health tool, but as a way to describe the "average man" in census data. It became a medical screening tool in the 1970s, and it remains the world's most widely used weight classification system despite significant limitations.
The formula
BMI = weight (kg) ÷ height² (m²)
For imperial units: BMI = (weight in lbs × 703) ÷ height² (inches²)
A person who is 170 cm tall and weighs 65 kg: BMI = 65 ÷ (1.70²) = 65 ÷ 2.89 = 22.5 (Normal weight).
WHO categories
| BMI | Category | |---|---| | Below 18.5 | Underweight | | 18.5–24.9 | Normal weight | | 25–29.9 | Overweight | | 30 and above | Obese |
What BMI misses
BMI is a blunt instrument. Two people with identical BMIs can have very different health profiles:
- Muscle mass: A 90 kg rugby player and a 90 kg sedentary office worker at the same height have the same BMI — but vastly different body compositions. BMI cannot distinguish fat from muscle.
- Fat distribution: Visceral fat (around the abdomen) carries much higher cardiovascular risk than subcutaneous fat (under the skin). BMI measures neither.
- Age and gender: Older adults naturally carry more fat at the same BMI; women carry more fat than men at the same BMI. The WHO thresholds don't adjust for this.
The Indian adjustment
Multiple studies (including the Consensus Statement by the Indian Diabetes Federation) show that South Asians, including Indians, develop metabolic complications (insulin resistance, type 2 diabetes, hypertension) at lower BMI thresholds than Western populations. Recommended Indian-specific cut-offs: overweight at BMI ≥ 23, obese at BMI ≥ 25 — versus the WHO standard of 25 and 30.
This tool uses the standard WHO thresholds for global comparability. Consult a doctor for population-specific guidance.
Better complements to BMI
- Waist circumference: Men > 94 cm, women > 80 cm signal elevated risk regardless of BMI.
- Waist-to-height ratio: Values above 0.5 correlate strongly with cardiometabolic risk across ethnicities.
- Body fat %: Measured by DEXA scan or bioimpedance — the gold standard for body composition.