To wonder why people pay so much attention to BMI, when waist to height ratio is a better indicator?

[WaisttoheightnotBMI]

Many scientists have said for years now that BMI is outdated - it shows how much you weigh but not where you carry most of that weight.

This is really important for women, because many women are pear-shaped. Carrying fat around your lower half means you're carrying a lot of subcutaneous fat, which can actually protect
your health from serious illnesses like heart disease compared to carrying a lot of visceral fat (around your stomach, which is dangerous as its near to your internal organs).

So you could have a higher BMI but a healthy waist to height ratio because your waist is small or average in proportion to your height.

Take this from Harvard www.hsph.harvard.edu/obesity-prevention-source/obesity-definition/abdominal-obesity/:
"The study found that even women at a “normal weight” BMI less than 25 were at a higher risk, if they were carrying more of that weight around their waist".

Also from Harvard www.health.harvard.edu/staying-healthy/big-thighs-may-be-wise#:~:text=Researchers%20tracked%20the%20volunteers%20for,than%20those%20with%20thin%20thighs.

"Although the BMI provides a reasonably accurate reflection of body fat, it does not tell how that fat is distributed. Research shows that not all fat is created equal. In fact, fat plastered around the body's internal organs (visceral fat) is much more dangerous than fat layered beneath the skin (subcutaneous fat); that's why liposuction and "tummy tuck" operations may improve your profile but won't help your metabolism or your health".

I feel like people here frequently talk about BMI and judge how healthy someone is or isn't based on their BMI, when that's not even the most effective indicator - could we start considering waist to height ratio more now?

@110APiccadilly

Practicality I think - BMI is very simple and doesn't change much depending on who's measuring. If you've got to measure someone's waist that's an extra faff, and also you've got to judge exactly where their waist is. Almost anyone who's had a baby will be able to tell you that their fundal height seemed to be measured differently each time - I imagine waist measurement would also suffer from this.

BMI is only one part of the picture - there's also bodyfat ratios you could look at as well as waist measurement, given that BMI is also affected by having a lot of muscle. To say nothing of lifestyle - a smoker with a BMI of 23 is quite likely to be less healthy overall than a non-smoker with a BMI of, say, 29, even though the non-smoker is overweight. But it's a very easy part to measure and standardise, so I can see why it's used so much.

Very good point raised about lifestyle - smoking and drinking are important indicators! Also relevant when people say they eat endless amount of junk but don't gain weight - that's still going to be bad for their health.

@ClariceQuiff

And for people saying 'oh that doesn't work for me because I'm an apple shape' isn't that the point? Fat around your waist is more risky than fat elsewhere? So sorry, but it's worth doing something about.

If you have narrow hips, it's hard to achieve the supposedly healthiest ratio, even if there's very little fat round your middle.

Yes, my measurements are 34, 26, 34 at a bmi of 20. I wear a 6 on bottom to fit my hips and 10 on top to fit my chest. When I was very underweight I was 32, 25, 32. So my ratio is okay I think but not if I gain weight.

Honestly, because they can say BMI isn’t this that and the other

But a waist to height ratio is much harder to wiggle out of

@StripedMousse @Sidge @ChazsBrilliantAttitude @CharacterForming @fellrunner85
I think where waist to height ratio is especially useful is showing that nuance - when you give the example of someone having a BMI over 30 being obese and needing to change, then yes that is extreme and most people wouldn't deny they'd need to lose weight at that point. But it's for people with middling or slightly high BMIs where actually, the waist to height ratio is more useful, it shows maybe you don't have to worry about much since your waist is small - fat accumulation near your vital organs is where the health issues really lie.

@fellrunner85

Doesn't really matter what the measurement is, you will still get people denying they're overweight. If it's not "oh, but rugby players" it'd be "oh, but I just carry more weight there." Either way, people will carry on insisting they look "gaunt" at below 10st or a size 12.

Yes, BMI isn't perfect, but on a population level, it's one of the many tools you can use. Funny how people saying "oh but what about pro athletes" are never pro athletes. And in fact most very muscular sportspeople would be well within a healthy BMI range anyway.

Totally agree.

Also, even most pro female athletes aren't muscly enough to have an overweight BMI.

@lumpofcomfort

I don't think either way is perfect as a blunt tool. I'm very slim, have a BMI of 18.5 but due to my body shape am very straight up and down and have no waist and narrow hips. I have barely any fat on either my belly or hips but my waist hip ratio is 0.83 due to my natural frame, which is only just in the "healthy" category.

Yes that's your waist to hip ratio, but your waist to height ratio must be low if you are both slim and straight up and down - you don't store much fat around your stomach which is very good for your health. But your waist to hip ratio tells us that if you did gain lots of weight it would likely be in your stomach so that would be more damaging.

If my BMI is at the upper end of healthy or overweight my waist is too large, so it works for me. I definitely feel overweight if it goes over 25. I really need to be around bmi 22 to have a healthy waist size as I'm apple shaped.

@picklemewalnuts

There's a hip/waist ratio, too. Bizarrely I fell foul of that one when I lost weight. Mine got worse rather than better.

No one ever talks about fitness, but surely that's more telling than BMI?

Why don't we have standardised norms for physical activity, like a staircase test and a standing with your arms out test?

My BMI was bad for years. It's much better now, but what makes a difference day to day is how fit I am. I've been obese and fit, and obese and unfit.

Fitness is a better indicator of health than appearance, weight or diameter surely?

A nutritionist reassured me that BMI is a number, not a fitness indicator. It points you in the direction of potential issues. What matters is cholesterol level, blood pressure, blood sugar levels etc. If all those indicators are good, BMI doesn't matter.

I also had a nurse look like she was sucking lemons because my middle age road test result came out green despite my obesity. Not smoking, drinking, being active, low blood pressure and cholesterol all outweighed my obesity. She'd been expecting a glaring red klaxon and seemed most disappointed I wasn't likely to die in the next ten years.

I agree that fitness is really important. Though I'm curious, when you say you've been obese and unfit and obese and fit, did your fitness/more exercise during obesity not help you lose a bit more weight?

@Leftleg

If my BMI is at the upper end of healthy or overweight my waist is too large, so it works for me. I definitely feel overweight if it goes over 25. I really need to be around bmi 22 to have a healthy waist size as I'm apple shaped.

That's exactly where the waist to height ratio is useful - you're recognising that some 'healthy' BMIs would be unhealthy for you because of your waist size. That's great but many people wouldn't, they'd just say well I fall within a healthy BMI so I'm healthy, without considering their waist.

@SartresSoul

I’m an hourglass so I gain weight pretty evenly everywhere. The only part of me that really stays slim is my back and shoulder region, everywhere else gains. I don’t know where my body shape falls in this thinking since I gain a big bum and also a bit around the mid section. I prefer to go on BMI, easier to manage my weight relying on that.

You can work out what your body shape is by calculating your waist to hip ratio!

@echt

I urge you all to be 65+:o

My rheumatologist said I needed to lose some weight and build up my quads to take pressure off my sore knees: some osteoarthritis, but general wear and tear, and not why I am referred to him.

I go by clothes fit so knew I was overweight. Did the BMI = overweight. Did the 65+ BMI =normal. Unkindly the scale is called geriatric, but there you go.

Anyway, I'm on it, have painlessly lost several kilos, got the legs going, etc.

Great job, wishing you all the best !

@CeeceeBloomingdale

I am similar to *@Iamclearlyamug*.

I am apple shaped and as I'm short and also short waisted it's the worst combination. My waist measurement will look large whatever my weight and I have big boobs and broad shoulders too meaning my BMI will rarely be much under 25 but my waist will measure much larger than average no matter what I weigh. My healthiest weight is between 9 and 9.5 stones although I'm normally heavier. Even at 8 stone my waist was over 30".

Similar here. My BMI is currently 21.3 but waist is 32 inches. Even at my lightest with a BMI of less than 20 my waist was still at least 30 inches.

Also, even most pro female athletes aren't muscly enough to have an overweight BMI

THIS. Totally this. I find it really irritating when people claim they are overweight on BMI because they're "muscular" - what, more muscular than boxer Nicola Adams (8st), heptathlete Jess Ennis Hill (9st), cyclist Laura Kenny (8st 2), weightlifter Zoe Smith (9st 2)... etc etc? (Weights from Wikipedia, so won't be spot on, but won't be far wrong either).

Or let's look at one of the heaviest, biggest, sportswomen the GB team has had - Fatima Whitbread. She was the butt of jokes for being so "huge" - yet apparently she weighed 10st 10. At 5ft 6.

Are all these people claiming BMI isn't accurate because they're "muscular" honestly claiming that they have more muscle mass than any of these athletes...?

Well yes inherently if you carry fat around your waist, that's more risky health-wise than people who carry it around their thighs, bums etc.
Just because you can't shift fat from specific zones, doesn't make that fact untrue.
I'm nearly 44, short & plump. Finally started to shift my waist fat by starting running 5km every day. 30 years of netball, rugby, rowing, weights & swimming & I still had a fat waist, unfortunately ~because I hate it~ running is the only exercise that has made an impact on body fat.
And eating & drinking a lot less.

@Fellrunner85

Also, even most pro female athletes aren't muscly enough to have an overweight BMI

THIS. Totally this. I find it really irritating when people claim they are overweight on BMI because they're "muscular" - what, more muscular than boxer Nicola Adams (8st), heptathlete Jess Ennis Hill (9st), cyclist Laura Kenny (8st 2), weightlifter Zoe Smith (9st 2)... etc etc? (Weights from Wikipedia, so won't be spot on, but won't be far wrong either).

Or let's look at one of the heaviest, biggest, sportswomen the GB team has had - Fatima Whitbread. She was the butt of jokes for being so "huge" - yet apparently she weighed 10st 10. At 5ft 6.

Are all these people claiming BMI isn't accurate because they're "muscular" honestly claiming that they have more muscle mass than any of these athletes...?

And don’t get me started on “big boned”!

Yes frames vary but not that significantly…

I actually think bmi is a much better tool for men as by and large most weight goes on their torso

For women a mix of bmi and hip/waist/height is probably more useful

However I do think if you are fit and healthy, dont smoke then having a bmi of 26/27is neither here or there

Haha this thread is reminding me of a recent trip to the GP. I commented that I'm losing weight since having a baby (I wanted to get that in there before I had the inevitable lecture on healthy eating and exercise) but he told me I didn't look overweight at all and was genuinely surprised when I told him my BMI! I felt like saying "ah yes, we have lost sight of what a healthy weight looks like, haven't we", as is the standard mn response, but I didn't

What about split stomach muscles from having a baby? (I can’t remember the technical term).

I am as fit as, and weigh same as, pre children. My BMI is 22. Pre children I had a tiny waist, now it would put me in the danger category.

I was just getting into morbid obesity I am now classed as overweight still got a bit to go until healthy weight. I'd say BMI is accurate and I'm hourglass shaped I feel so much better being a lower BMI. My joints don't hurt anymore , I can run up the stairs.
I think a lot of overweight/obese people don't like the BMI scale so say it isn't accurate I did before I lost the weight.

@Wherearemymarbles

I actually think bmi is a much better tool for men as by and large most weight goes on their torso

For women a mix of bmi and hip/waist/height is probably more useful

However I do think if you are fit and healthy, dont smoke then having a bmi of 26/27is neither here or there

Yes this is exactly the point I'm making - for men, if their BMI is high its likely their waist to height ratio is high too because they store fat around their stomachs. For women, we shouldn't neccessarily be so obsessed with BMI as many here seem to be.

For everyone talking about BMI and muscle @Fellrunner85 @DazzlePaintedBattlePants @Nat6999 @InvincibleInvisibility @Dentistlakes @StripedMousse @MyAnacondaMight @BiBabbles @Octomore @Sidge

It's true that this isn't relevant for most people, most of us aren't so muscular that it gives us an overweight BMI - that's why I didn't mention that weakness of BMI myself.
But surely the waist to height ratio still has this advantage - if you're very fit and muscular you won't have a big waist, so you'll still have a good waist to height ratio. So waist to height ratio accounts for muscle, your body shape and is more predictive of health like cardiovascular risk factors than BMI.

I’m a bit confused about the concept of visceral fat - despite having read about it. It’s fat that is packed around your organs rather than under your skin fat which you can pinch? So if you have a flabby tummy but you can pinch it does that count as visceral fat? How do I know if there’s fat sneaking around my liver or what have you?

I do worry about it because I’m slim but the only place I will put on weight is around my abdomen and back. I have narrow hips so there’s nowhere for fat to speed out over and it doesn’t go on my bum 🤷🏻‍♀️ But it’s all flab that I can pinch so it’s not round my organs??

@callingon

I’m a bit confused about the concept of visceral fat - despite having read about it. It’s fat that is packed around your organs rather than under your skin fat which you can pinch? So if you have a flabby tummy but you can pinch it does that count as visceral fat? How do I know if there’s fat sneaking around my liver or what have you?

I do worry about it because I’m slim but the only place I will put on weight is around my abdomen and back. I have narrow hips so there’s nowhere for fat to speed out over and it doesn’t go on my bum 🤷🏻‍♀️ But it’s all flab that I can pinch so it’s not round my organs??

From what I've read, I think visceral fat is best indicated by your waist size. All of us have some visceral fat, around 10% of body fat. But to know if it's excessive you'd have to see if your waist size is excessive. Is your waist to height ratio between 0.42-0.48? If you're slim you might still fall in this range, but obviously it would be more dangerous if you exceeded it.

I'm sure my boobs weigh a stone

@CharacterForming

I agree that waist measurement is an important guide to whether you're at a healthy weight.

I have however noticed that people who say on MN that BMI is bollocks because they're a size ten at BMI 32 and they look "gaunt" if they drop below a BMI of 28 (I may be exaggerating for effect) normally go very quiet if you say "possibly, we're all different, what's your waist measurement?"

Also, some people will say because their BMI is below 25, they are not overweight, when actually they might have rolls of fat. To be fair, some people also think as long as they are somewhere in the healthy weight range for their height, it means they are a healthy weight for THEM, so it's not just BMI charts that people choose to interpret to suit themselves.