Why It's Time To Evolve From BMI & Improve True Markers Of Metabolic Health

Body mass index (BMI) considers height and weight to grossly estimate one’s weight/adiposity status13 (i.e., underweight, healthy, overweight, obesity). While useful in certain clinical settings and for broad data sets in epidemiologic (population-level) research, BMI is not as useful at the individual level if your goal is a comprehensive and personalized approach to optimize metabolic health.

BMI is insensitive to body composition nuance (e.g., a muscular and highly fit athlete may register in the “overweight” or “obese” categories), gender, and racial uniqueness. As mbg Collective member and the father of functional medicine Jeffrey Bland, Ph.D., previously shared with mbg: “The BMI standard was developed for an idealized Caucasian male, and the thresholds remain rather oblivious to important discrepancies warranted by gender and ethnicity.” 

Also, weight is an incredibly narrow view of metabolic health. Functional medicine nutritionist Brooke Scheller, DCN, CNS, explains, “Metabolism isn’t just about weight. It actually has more to do with how our body uses the food we eat and converts it to fuel for energy.”

“It’s hurtful to reduce personal health to a number that takes no account of your behaviors and the socioeconomic pressures that play major roles in so many people’s lives,” Bland shares. And registered dietitian and intuitive eating counselor Courtney Vickery, M.S., R.D., L.D., astutely points out that “weight can fluctuate for many reasons, such as hormones, water retention, and muscular growth.”

Indeed, metabolism and metabolic health are so much more than a number on a scale. After all, it’s almost 2023; thus, it’s time to graduate, evolving from an antiquated and oversimplified view of weight (i.e., energy in, energy out) and related metrics (BMI). 

As Cate Shanahan, M.D., medical director of ABC Metabolic Health Center and bestselling author of Deep Nutrition and The FATBURN Fix, explains, “The key to losing weight is recognizing that it’s not a problem of willpower but of metabolic breakdown. You can fix your metabolism.”