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Rachel V Thomas

Checking BMI For Body Weight? It Can Wrongly Mark You As Overweight or Obese, Says Study

Long considered a standard tool for assessing body weight, Body Mass Index (BMI) may not be as reliable as once believed. A new study shows that relying on BMI can incorrectly classify people as overweight or obese.

When a team of Italian researchers used the gold standard technique of dual-energy X-ray absorptiometry (DXA) to measure body fat in the general population, they found that the traditional WHO-approved BMI classification system misidentified a significant number of people as having overweight or obesity.

A total of 1,351 adults of mixed gender aged between 18 and 98 years were checked for their body weight using the DXA system.

The results, published in the journal Nutrients, revealed that more than one-third (34 percent) of those with obesity defined by BMI had been misclassified and should be in the overweight category.

For those with an overweight BMI, DXA showed that more than half – 53 percent – had been misclassified – three quarters of those misclassified fall into the normal weight category, while the other quarter should have been classified as having obesity.

The DXA analysis found that the prevalence of overweight and obesity across the cohort was around 37 percent overall (23.4 percent overweight, and 13.2 percent obesity, compared to 26.2 percent and 14.1 percent with BMI).

“In the past few years, there has been a lot of criticism of the BMI system due to its inability to accurately capture body fat percentage or distribution, to correctly categorise weight status based on adiposity,” said Professor Marwan El Ghoch, of the Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Also read: <a href="https://www.healthandme.com/health-wellness/your-bmi-does-not-reflect-your-health-new-study-warns-how-it-misses-a-key-health-aspect-article-152955190" data-type="tilCustomLink">Your BMI Does Not Reflect Your Health: New Study Warns How It Misses A Key Health Aspect</a>

Despite these concerns, BMI as a weight classification system continues to be used in the general population in primary healthcare (i.e., general practitioners) and non-clinical (i.e., policy and health insurance) settings, he added.

The researchers urged revising public health guidelines to consider combining direct body composition or their surrogate measures, such as skinfold measurement or body circumference, with the waist-to-height ratio, with BMI, while assessing weight status in the general population.

<h2>Waist-to-Height Ratio May Be More Accurate: The India Story</h2>

In January 2025, India revamped its obesity guidelines, and the new approach focused on abdominal obesity and comorbid diseases, rather than just BMI.

According to the redefining team, it was essential to move beyond BMI-only approaches to tackle the ever-growing number of people related to other major health risks. They stated that while BMI can be a screening tool, obesity must be defined by body fat.

“BMI should be used for screening purposes, but obesity should be confirmed ideally by a measure of body fat wherever feasible, or another measure such as waist circumference, WHR, or Waist-to-height ratio,” Dr. Naval Vikram, Professor of Medicine, at AIIMS, New Delhi, was quoted as saying to IANS at the time.

Also read: <a href="https://www.healthandme.com/health-news/41-million-children-aged-5-19-living-with-high-bmi-in-india-study-article-153888395" data-type="tilCustomLink">41 million children aged 5-19 living with high BMI in India: Study</a>

It recognizes abdominal fat — closely linked to insulin resistance — as a key factor in the diagnosis. It integrates the presence of comorbidities — such as diabetes and cardiovascular disease — into the diagnostic process.

The revised guidelines also introduce a two-stage classification system, addressing both generalized and abdominal obesity. 

Stage 1 Obesity: Increased adiposity (BMI &gt; 23 kg/m²) without apparent effects on organ functions or routine daily activities.

Stage 2 Obesity: Advanced state of obesity with increased BMI more than 23 kg/2, and abdominal adiposity; excess Waist Circumference or Waist-to-Height Ratio.

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Long considered a standard tool for assessing body weight, Body Mass Index (BMI) may not be as reliable as once believed. A new study shows that relying on BMI can incorrectly classify people as overweight or obese. When a team of Italian researchers used the gold standard technique of dual-energy X-ray absorptiometry (DXA) to measure body fat in the general population, they found that the traditional WHO-approved BMI classification system misidentified a significant number of people as having overweight or obesity. How Is The BMI Wrong?A total of 1,351 adults of mixed gender aged between 18 and 98 years were checked for their body weight using the DXA system. The results, published in the journal Nutrients, revealed that more than one-third (34 percent) of those with obesity defined by BMI had been misclassified and should be in the overweight category. For those with an overweight BMI, DXA showed that more than half – 53 percent – had been misclassified – three quarters of those misclassified fall into the normal weight category, while the other quarter should have been classified as having obesity. The DXA analysis found that the prevalence of overweight and obesity across the cohort was around 37 percent overall (23.4 percent overweight, and 13.2 percent obesity, compared to 26.2 percent and 14.1 percent with BMI). “In the past few years, there has been a lot of criticism of the BMI system due to its inability to accurately capture body fat percentage or distribution, to correctly categorise weight status based on adiposity,” said Professor Marwan El Ghoch, of the Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.Also read: Your BMI Does Not Reflect Your Health: New Study Warns How It Misses A Key Health Aspect Despite these concerns, BMI as a weight classification system continues to be used in the general population in primary healthcare (i.e., general practitioners) and non-clinical (i.e., policy and health insurance) settings, he added. The researchers urged revising public health guidelines to consider combining direct body composition or their surrogate measures, such as skinfold measurement or body circumference, with the waist-to-height ratio, with BMI, while assessing weight status in the general population.Waist-to-Height Ratio May Be More Accurate: The India StoryIn January 2025, India revamped its obesity guidelines, and the new approach focused on abdominal obesity and comorbid diseases, rather than just BMI. According to the redefining team, it was essential to move beyond BMI-only approaches to tackle the ever-growing number of people related to other major health risks. They stated that while BMI can be a screening tool, obesity must be defined by body fat. “BMI should be used for screening purposes, but obesity should be confirmed ideally by a measure of body fat wherever feasible, or another measure such as waist circumference, WHR, or Waist-to-height ratio,” Dr. Naval Vikram, Professor of Medicine, at AIIMS, New Delhi, was quoted as saying to IANS at the time.Also read: 41 million children aged 5-19 living with high BMI in India: Study What Do The New Guidelines Say It recognizes abdominal fat — closely linked to insulin resistance — as a key factor in the diagnosis. It integrates the presence of comorbidities — such as diabetes and cardiovascular disease — into the diagnostic process. The revised guidelines also introduce a two-stage classification system, addressing both generalized and abdominal obesity.  Stage 1 Obesity: Increased adiposity (BMI > 23 kg/m²) without apparent effects on organ functions or routine daily activities. Stage 2 Obesity: Advanced state of obesity with increased BMI more than 23 kg/2, and abdominal adiposity; excess Waist Circumference or Waist-to-Height Ratio.

checking bmi for body weight? it can wrongly mark you as overweight or obese, says study

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