Is BMI an Accurate Measure of Healthy Weight?

Woman Dealing with Depression and Eating Disorders

Is Body Mass Index (BMI) an accurate way to measure whether you are at a healthy weight? It has been the standard of measurement for healthy weight for a number of years, but aren’t there many other factors that should be taken into consideration?

BMI is a medical scale to determine if a person is within a healthy weight range or not. Often BMI and waist circumference are used in screenings to estimate weight in relation to disease risk [1].


In a 2006 U.S.Department of Health and Human Services guideline for school screening programs, it recommended that schools screen for various health-related issues.

Weight concerns among school-aged children started in the late 1990’s when the Centers for Disease Control (CDC) and the National Health Examination Surveys (NHANES) began to target and identify childhood obesity.

Schools began to evaluate children’s health using BMI and how changes in school curriculums and environment impact the students over time.

It’s Not Just Body Mass Index, Its B.E.G.

Often with determining if a child or adult is of healthy weight, more than BMI is needed for a proper evaluation. Physicians and health organizations are looking more at B.E.G: Behavior, Environmental, and Genetic factors for what measures healthy weight [3].


Behavior encompasses food choices, physical activity, and efforts taken to maintain a healthy weight. Is the person making healthy food choices? Is the person’s calorie intake too high? Are they exercising enough? What is behind the choices that are being made?


Another factor in determining healthy weight is one’s environment. It plays a decisive role in shaping a person’s habits and lifestyle, and in today’s society, people are living a more sedentary lifestyle.

They are working more at a desk, or they are shopping online. Thanks to Uber, and their offering of Ubereats, people can now have most any type of food delivered to their front door.

Unfortunately, our fast-paced lives frequently drive us to choose convenience in lieu of health. Besides, it is easier to get takeout than to buy and prepare food that is healthier.


Genetics, the third measure of B.E.G., plays a crucial role in our weight. One’s family history could predispose them to specific health issues such as high cholesterol, diabetes, or high blood pressure.

People may also be genetically pre-dispositioned to be overweight. This pre-disposition can likely to lead to obesity if it is not closely monitored.

How to Counter B.E.G.

Maintaining a healthy weight involves a variety of factors. One is changing eating habits. This change can include finding help from a nutritionist to create a meal plan and learn new healthy eating habits.

Woman outside with belief shes overweight and has a high Body Mass IndexAnother factor is increasing physical activity. Being able to exercise and participate in activities you enjoy can lead to a healthier lifestyle and a healthier body.

Involve your family and friends to support you as you begin these lifestyle changes. It may be difficult at first to stay the course in the new routines, but having the support of loved ones and sharing your struggles can help make a huge difference in maintaining a healthy lifestyle.

Joining a support group is also an option for those who need additional support. Many local support organizations offer weekly groups. Some even provide meal support during their groups.

Early Measurements

BMI was established in the 1800s as a tool for research purposes, and in the 1970s it was found to be the best formula to measure a person’s body fat percentage [4].

According to Dr. Francisco Lopez-Jimenez, an obesity expert, BMI was a measurement created for epidemiology that could be used in research [4].

Within the 1980s BMI became a recommended measurement tool by several national health organizations, and it became popular among health professionals as a way to measure a person’s health and percentage of fat.

It then became popular for school screenings as the childhood obesity epidemic grew.

What’s the Downfall

BMI is the standardized research tool making it popular, but many professionals claim it does not tell the entire story of a person’s health or weight.

Many people who are deemed overweight or obese according to their BMI may have high muscle mass, like in athletes, which BMI does not take into account.

BMI also takes into account an individual’s waist size. A person’s BMI may say they are healthy, but if their waist size is large due to belly fat, it can pose serious health risks such as a stroke or heart attack.

In the Journal of Frontiers in Public Health, a study found that using BMI as the sole measure of health missed 50% of cases of individuals who had what was determined to be dangerous fat that could pose a risk to their health [4].

In another study, it was found that BMI was off as much as 19% in children and when used to measure weight in boys who go through puberty, they add muscle at a rapid pace, and girls add fat, which BMI does not account for [4].

BMI also does not account for race or ethnicity. Depending on a person’s race, there can be variances in fat and muscle in people’s genetic makeup.

In previous research, African-Americans tend to have more muscle than fat compared to Caucasians. This will lead to an African-American showing a higher BMI, but in actuality, he or she can be healthier. In Asia, the Asian population presents is a higher risk for heart disease at a lower BMI than non-Asians.

Other Measures

There are other tools available to determine a healthy weight in children and adults, but one of the more encompassing ways is to look at a person’s health history, genetics, behavior, and lifestyle choices. These all play a roll in a person’s health and health risk factors.

Woman celebrating success in ED treatment

Determining a healthy weight is not just defined by BMI. It takes a number of factors to determine if a person is healthy or not.

Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is an Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.


[1] Assessing Your Weight. (2015, May 15). Retrieved January 12, 2018, from
[2] Ikeda, J. P., Crawford, P. B., & Woodward-Lopez, G. (2006, November 08). BMI screening in schools: helpful or harmful | Health Education Research | Oxford Academic. Retrieved January 18, 2018, from
[3] Obesity Action Coalition » What is Obesity? (n.d.). Retrieved January 18, 2018, from
[4] Christensen, J. (2017, August 16). Calling BS on BMI: How can we tell how fat we are? Retrieved January 21, 2018, from

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on March 9, 2018.

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