About Body Mass Index for Adults

To continue the American Chiropractic Association's October educational campaign, National Chiropractic Health Month, Why Weight? Get Healthy! the following educational information about Body Mass Index is provided.

What is BMI?
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). 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.

Why does the Center for Disease Control and Prevention use BMI to measure overweight and obesity?
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.

How is BMI calculated and interpreted?

Calculation of BMI
BMI is calculated the same way for both adults and children. The calculation is based on either of the following two formulas:

Measurement Units
(1)Kilograms and meters (or centimenters)
Formula and Calculation: 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

(2)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

Interpretation of 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

For example, here are the weight ranges, the corresponding BMI ranges, and the weight status categories for a sample height of 5'9".

Height --Weight Range-----BMI-----Weight Status
5' 9" --124 lbs or less --Below 18.5---Underweight
--125 lbs to 168 lbs ---18.5 to 24.9---Normal
--169 lbs to 202 lbs ---25.0 to 29.9--Overweight
--203 lbs or more -----30 or higher--Obese

How reliable is BMI as 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).

For more information about the assessment of health risk for developing overweight- and obesity-related diseases, visit the following these Web pages from the National Heart, Lung, and Blood Institute at www.nhlbi.nih.gov:

• Assessing Your Risk
• Body Mass Index Table
• Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults

What are the health consequences of overweight and obesity for adults?
The BMI ranges are based on the relationship between body weight and disease and death. Overweight and obese individuals are at increased risk for many diseases and health conditions, including the following:

• Hypertension
• Dyslipidemia (for example, high LDL cholesterol, low HDL cholesterol, or high levels of triglycerides)
• Type 2 diabetes
• Coronary heart disease
• Stroke
• Gallbladder disease
• Osteoarthritis
• Sleep apnea and respiratory problems
• Some cancers (endometrial, breast, and colon)

For more information about these and other health problems associated with overweight and obesity, visit the NHLBI's Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults at www.nhlbi.nih.gov.

Is BMI interpreted the same way for children and teens as it is for adults?
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.

This educational information is provided by the American Chiropractic Association.