The body mass index (BMI) is under fire—many healthcare professionals, researchers, and fitness experts are questioning its usefulness
For over 180 years, the Body Mass Index (BMI) has been used to categorize individuals based on their weight relative to height. Invented in the 1830s by Belgian mathematician Adolphe Quetelet —not a physician — BMI was never intended to be a diagnostic tool. Yet, it has become one of the most commonly used metrics in modern healthcare.
From annual checkups to insurance assessments, BMI has influenced decisions about people’s health across the globe, including in India. However, a growing movement of healthcare professionals, researchers, and fitness experts are now questioning whether it has outlived its usefulness.
A Flawed Science
Critics of BMI argue that it offers a simplistic and often misleading picture of health. It does not differentiate between fat and muscle, nor does it consider age, gender, ethnicity, or fat distribution — critical factors in understanding a person’s true health profile.
“BMI is a poor indicator of individual health,” says Dr. Meenakshi Menon, (endocrinologist) “It treats all body types as the same and fails to account for factors like visceral fat or lean muscle mass. A person with high muscle mass may be classified as overweight or obese, which is misleading.”
Indeed, athletes with low body fat but high muscle density often fall into the “overweight” or “obese” categories. Meanwhile, individuals with normal BMI may still carry dangerous levels of visceral fat, increasing their risk of conditions like diabetes and heart disease.
Indian Bodies, Global Standards
Another glaring issue with BMI is its one-size-fits-all approach. Most BMI guidelines were based on European populations and do not take into account regional and ethnic differences. For South Asians, this has serious consequences.
“South Asians tend to develop abdominal obesity and insulin resistance at lower BMIs compared to Western populations,” explains Dr. Menon “By the time a South Asian hits a ‘normal’ BMI of 24, they may already be at high risk for Type 2 diabetes or heart disease.”
In 2004, the WHO acknowledged this by suggesting lower BMI thresholds for Asian populations, but even then, the root problems of the metric were not addressed.
The Psychological Toll
The use of BMI also has psychological ramifications. For many, a BMI label can fuel body image issues, disordered eating, and shame — especially in a culture where appearance already plays a large role.
“BMI creates unnecessary anxiety and stigma,” says Neha Sinha, a fitness coach and body positivity advocate. “I’ve had clients who were healthy, energetic, and metabolically fit, yet felt ‘fat’ or ‘unworthy’ because their BMI told them they were overweight.”
This stigma can deter people from seeking medical help or embracing exercise for fear of judgment, ultimately causing more harm than good.
Better Alternatives
The fall of BMI has paved the way for more nuanced approaches to health assessment. Metrics like waist-to-hip ratio, body fat percentage, and even wearable fitness tracking data offer more comprehensive insights.
“Tools like DEXA scans or bioelectrical impedance provide better assessments of fat and muscle distribution,” says Dr. Rupal Shah, a nutritionist and preventive medicine specialist. “We also consider lipid profiles, blood sugar levels, and blood pressure to build a more accurate picture of health.”
Some experts also advocate for a shift toward function-based metrics. How well a person can move, recover, and manage stress may tell more about their well-being than a number on a chart.
Movement Gains Momentum
Globally and in India, the call to move beyond BMI is gaining traction. Several healthcare organizations, including the American Medical Association, have begun re-evaluating their reliance on the metric. Meanwhile, Indian wellness startups and holistic clinics are already shifting toward personalized assessments.
“There is no one-size-fits-all in healthcare,” says Neha Sinha. “We’re finally realizing that health isn’t just a number—it’s a complex, evolving spectrum. And we need tools that respect that complexity.”
The Way Forward
While BMI might not disappear overnight, its dominance is undeniably fading. In its place, a new era of personalized, inclusive, and evidence-based health assessments is taking root. For patients and practitioners alike, this shift represents an opportunity to redefine what “healthy” truly means — beyond weight, beyond numbers, and beyond BMI.
