What Is a Healthy Weight?

August 08, 2023

Maintaining a healthy weight is crucial for overall health. It is well known that obesity is one of the leading causes of morbidity and mortality,¹ associated with an array of health issues such as dyslipidemia (ie, imbalance of blood lipid levels), coronary artery disease (ie, diseases of the heart’s blood vessels), diabetes, sleep apnea, liver disease, and certain types of cancers.² On the other hand, being underweight is also associated with poor health and can put individuals at risk for reproductive dysfunction, mental disorders, neurologic dysfunction, among others.³ There are various ways to measure one’s body weight but body mass index (BMI) and waist circumference measurements are used commonly to assess overall health.

Body Mass Index

BMI is a system used to estimate body fat and compare weights independent of stature across a population.⁴ It is calculated by dividing body weight (kg) by the square of height (m²).

Classification	BMI (kg/m²)
Underweight	<18.5
Normal	18.5-24.9
Overweight	25.0-29.9
Obesity	30.0-39.9
Extreme Obesity	>40

BMI has been widely used to indicate and predict one’s overall health. Higher BMI is a risk factor for developing type 2 diabetes mellitus and is associated with a higher prevalence of hypertension (ie, high blood pressure) and (ie, imbalance of blood lipid levels).⁵ Additionally, BMI is strongly associated with all-cause mortality as well as cancer, cardiovascular, respiratory, and other causes of death.⁶ However, it should be noted that BMI is not a perfect measure of body weight as it relates to health. BMI cannot calculate body fat percentage and tends to underestimate body fat in individuals with higher body mass and overestimate body fat in individuals with leaner body mass.⁴ In addition, even though it is known that abdominal adiposity (ie, fat around the waist) is associated with worse health outcomes, BMI does not account for differing body types.

Waist Circumference

Excess abdominal adiposity is associated with metabolic abnormalities linked with the development of type 2 diabetes mellitus such as insulin resistance, pancreatic b-cell dysfunction, and dyslipidemia.^7,8 Studies have consistently demonstrated abdominal obesity as being a major risk factor for cardiovascular disease as well.^9,10 Waist circumference is a simple and easy way to assess abdominal adiposity and is especially a powerful tool when used with BMI.¹¹ Although it is now encouraged that clinicians measure waist circumference routinely, individuals can also measure their waist circumference at home by using a tape measure just above the hipbones.^11,12

Waist Circumference Associated With Poor Health
Men	>40 inches
Nonpregnant Women	>35 inches

References:
1. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377(1):13-27. doi:10.1056/NEJMoa1614362
2. Mitchell N, Catenacci V, Wyatt HR, Hill JO. Obesity: Overview of an Epidemic. Psychiatr Clin North Am. 2011;34(4):717-732. doi:10.1016/j.psc.2011.08.005
3. Golubnitschaja O, Liskova A, Koklesova L, et al. Caution, “Normal” Bmi: Health Risks Associated with Potentially Masked Individual Underweight—Epma Position Paper 2021. EPMA J. 2021;12(3):243-264. doi:10.1007/s13167-021-00251-4
4. Zierle-Ghosh A, Jan A. Physiology, Body Mass Index. In: StatPearls. StatPearls Publishing; 2023. Accessed July 17, 2023. http://www.ncbi.nlm.nih.gov/books/NBK535456/
5. Khanna D, Peltzer C, Kahar P, Parmar MS. Body Mass Index (BMI): A Screening Tool Analysis. Cureus. 14(2):e22119. doi:10.7759/cureus.22119
6. Bhaskaran K, dos-Santos-Silva I, Leon DA, Douglas IJ, Smeeth L. Association of Bmi with Overall and Cause-Specific Mortality: A Population-Based Cohort Study of 3·6 Million Adults in the Uk. Lancet Diabetes Endocrinol. 2018;6(12):944-953. doi:10.1016/S2213-8587(18)30288-2
7. Magkos F, Fraterrigo G, Yoshino J, et al. Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans With Obesity. Cell Metab. 2016;23(4):591-601. doi:10.1016/j.cmet.2016.02.005
8. Zheng Y, Ley SH, Hu FB. Global Aetiology and Epidemiology of Type 2 Diabetes Mellitus and Its Complications. Nat Rev Endocrinol. 2018;14(2):88-99. doi:10.1038/nrendo.2017.151
9. Paley CA, Johnson MI. Abdominal Obesity and Metabolic Syndrome: Exercise as Medicine? BMC Sports Sci Med Rehabilitation. 2018;10(1):7. doi:10.1186/s13102-018-0097-1
10. Pedersen BK, Saltin B. Exercise as Medicine - Evidence for Prescribing Exercise as Therapy in 26 Different Chronic Diseases. Scand J Med Sci Sports. 2015;25(S3):1-72. doi:10.1111/sms.12581
11. Ross R, Neeland IJ, Yamashita S, et al. Waist Circumference as a Vital Sign in Clinical Practice: A Consensus Statement from the Ias and Iccr Working Group on Visceral Obesity. Nat Rev Endocrinol. 2020;16(3):177-189. doi:10.1038/s41574-019-0310-7
12. Assessing Your Weight. Centers for Disease Control and Prevention. Published June 9, 2023. Accessed July 17, 2023. https://www.cdc.gov/healthyweight/assessing/index.html

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