10.2: Assessing Body Weight and Body Composition
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Body Mass Index (BMI) is a number calculated from a person’s weight and height. BMI is a fairly reliable indicator of body fatness for most people. BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat, such as underwater weighing and dual energy x-ray absorptiometry (DXA). BMI can be considered an alternative for direct measures of body fat. Additionally, BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems.
How is BMI used?
BMI is used as a screening tool to identify possible weight problems for adults. However, BMI is not a diagnostic tool. For example, a person may have a high BMI. However, to determine if excess weight 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 screenings.
Calculating BMI is one of the best methods 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. The use of BMI allows people to compare their own weight status to that of the general population.
Other methods for Assessing Body Composition
Other methods to measure body fatness include skinfold thickness measurements (with calipers), underwater weighing, bioelectrical impedance, and dual-energy x-ray absorptiometry (DEXA). However, these methods are not always readily available, and they are either expensive or need highly trained personnel. Furthermore, many of these methods can be difficult to standardize across observers or machines, complicating comparisons across studies and time periods.
Figure \(\PageIndex{1}\).Other methods for Assessing Body Composition
Calculating BMI
BMI is calculated the same way for both adults and children. The calculation is based on the following formulas:
| Measurement Units | Formula and Calculation |
| Kilograms and meters/centimeters |
Formula: weight (kg) / [height (m)]² With the metric system, the formula for BMI is weight in kilograms divided by height in meters squared. Since height is commonly measured in centimeters, divide height in centimeters by 100 to obtain height in meters. Example: Weight = 68 kg, Height = 165 cm (1.65 m) Calculation: 68 ÷ (1.65)² = 24.98 |
| Pounds and Inches |
Formula: weight (lb) / [height (in)]² x 703 Calculate BMI by dividing weight in pounds (lbs) by height in inches (in) squared and multiplying by a conversion factor of 703. Example: Weight = 150 lbs, Height = 5’5″ (65″) Calculation: [150 ÷ (65)²] x 703 = 24.96 |
Interpreting BMI for adults
For adults 20 years old and older, BMI is interpreted using standard weight status categories that are the same for all ages and for both men and women. For children and teens, on the other hand, the interpretation of BMI is both age- and sex-specific. The standard weight status categories associated with BMI ranges for adults are shown in the following table.
| BMI | Weight Status |
| Below 18.5 | Underweight |
| 18.5 - 24.9 | Normal |
| 25.0 - 29.9 | Overweight |
| 30.0 and above | Obese |
The following link can be used as a quick reference guide to determine BMI:
https://www.nhlbi.nih.gov/health/edu...MI/bmi_tbl.htm
Reliability of BMI an Indicator of Body Fatness
The correlation between the BMI number and body fatness is fairly strong; however the correlation varies by sex, race, and age. These variations include the following examples:
- At the same BMI, women tend to have more body fat than men.
- At the same BMI, older people, on average, tend to have more body fat than younger adults.
- Highly trained athletes may have a high BMI because of increased muscularity rather than increased body fatness.
It is also important to remember that BMI is only one factor related to risk for disease. For assessing someone’s likelihood of developing overweight- or obesity-related diseases, the National Heart, Lung, and Blood Institute guidelines recommend looking at two other predictors:
- The individual’s waist circumference (because abdominal fat is a predictor of risk for obesity-related diseases).
- Other risk factors the individual has for diseases and conditions associated with obesity (for example, high blood pressure or physical inactivity).
Measuring Waist Circumference
Measuring waist circumference helps screen for possible health risks that come with overweight and obesity. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk goes up with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To correctly measure your waist, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.
Figure \(\PageIndex{2}\). Measuring Waist Circumference
Interpreting BMI for Teens and Children
Although the BMI number is calculated the same way for children and adults, the criteria used to interpret the meaning of the BMI number for children and teens are different from those used for adults. For children and teens, BMI age- and sex-specific percentiles are used for two reasons:
- The amount of body fat changes with age.
- The amount of body fat differs between girls and boys.
Because of these factors, the interpretation of BMI is both age- and sex-specific for children and teens. The CDC BMI-for-age growth charts take into account these differences and allow translation of a BMI number into a percentile for a child’s sex and age.
For adults, on the other hand, BMI is interpreted through categories that are not dependent on sex or age.