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Ask An Expert

How Does BMI Relate to Overall Health?

Jane Varner

Jane Varner, M.D.

Palo Alto Medical Foundation

Question:

I'm 54, eat well and exercise five times per week. Yet my BMI is 27, which translates as obese. Is a BMI of 27 really that indicative of my overall health?

Answer:

First of all, congratulations on getting all of that wonderful exercise! Exercise is so good for your physical AND mental health. Don't go calling yourself obese just yet. Technically, a BMI of 27 classifies you as “overweight” but not obese.

The recommended classifications for BMI (Body Mass Index) adopted by the National Institute of Health (NIH) and World Health Organization (WHO) groups are:
  • Underweight — BMI <18.5 kg/m2
  • Normal weight — BMI 18.5 to 24.9 kg/m2
  • Overweight — BMI 25.0 to 29.9 kg/m2
  • Obesity Class I — BMI of 30.0 to 34.9 kg/m2
  • Obesity Class II — BMI of 35.0 to 39.9 kg/m2
  • Obesity Class III — BMI =40 kg/m2. This type of obesity is also referred to as severe, extreme, or morbid obesity.

Note that these cutoffs are somewhat arbitrary and based on data collected exclusively from Caucasians. It may be that you have a greater muscle mass, which can translate to more pounds, increasing your BMI.

Measuring your waist circumference also helps to assess for “abdominal obesity.” In adults with a BMI of 25 to 34.9 kg/m2, a waist circumference greater than 35 in for women is associated with a greater risk of hypertension, type 2 diabetes, high cholesterol and heart disease. 

I also factor in family history. If you have multiple family members with heart disease, high blood pressure, high cholesterol, etc. then I may be a little more strict with the goals for BMI and waist circumference.

Make sure that you are hydrating well — drink at least one liter of water daily to start, followed by 8 oz of water for each 30 minutes of exercise and/or serving of caffeine or alcohol (both are diuretics, making you lose fluid through your kidneys).

At 54 years old, you are likely to be post-menopausal. Symptoms of menopause nearly always include:
  • Hot flashes (fan, anyone?)
  • Weight gain
  • Poor sleep
  • Irritability
  • Dry skin (including vaginal dryness)
  • Forgetfulness
  • Decreased libido

Studies show that exercise can help reduce all of these symptoms. If you typically do mostly cardio (walking, jogging, cycling, etc.) then think about learning some strength-building exercises. You can watch videos, consult a friend, or even hire a trainer. Building muscle increases your resting metabolism (calories burned at rest), offsetting that dreaded weight gain.

Personally, I think that you are doing great. I love that you are paying close attention to your health. Please don't get too caught up in the numbers…focus on the big picture.

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