Why BMI might be misleading your health – UAE doctors explain what really matters

 For years, BMI, Body Mass Index, has been treated like the final word on health metrics. It's quick, easy, and pops up everywhere, from annual health checkups to fitness apps. But is it really giving us the full picture?

Spoiler: not quite.

Yes, BMI is simple.

BMI = weight (kg) ÷ height² (m²)

That’s all it takes to sort you into neat little boxes: underweight, normal, overweight, or obese. But according to health experts, those boxes may be misleading, sometimes dangerously so.

BMI doesn’t measure what really counts: Your body fat, muscle, or where fat is stored, explains Dr. Patanjali Panduranga, Specialist Endocrinologist at Aster Hospital, Al Qusais. “And those factors can make all the difference.” Moreover, it does not take into account muscle mass, bone density, overall body composition

Sushma Ghag, Clinical Dietitian at Aster Hospital, Mankhool, elaborates that it is one of the tools used for nutrition screening and is not an individual diagnostic factor. As she explains, it is increasingly clear that BMI is a rather poor indicator of body fat percentage and does not capture information on fat distribution across different body sites. This means that someone with a ‘normal’ BMI could still be carrying dangerous visceral fat around their internal organs—a major risk factor for metabolic conditions.

“Very often, a person may fall within the normal BMI category but still have high visceral fat and fat deposition around the trunk,” Ghag notes. “These individuals can have a metabolically obese profile. They appear healthy, but their blood parameters can be elevated or borderline.”

Dr. Panduranga sees similar trends in his practice: “Such people are at a high cardiometabolic risk. And also, some individuals classified as ‘overweight’ by BMI may be metabolically healthy, which is also called metabolically healthy obesity.”

One of the biggest misconceptions around BMI is that being in the ‘overweight’ category always signals poor health. Not necessarily. “If you’re active, have good strength and endurance, and your metabolic markers are healthy, you’re likely in good health—regardless of BMI,” says Dr. Panduranga. “Muscle is denser than fat, so active individuals often fall into the ‘overweight’ category due to lean mass.”

Ghag offers a grounded perspective for anyone discouraged by a BMI label: “Your health is more important than a number. If someone is active, muscular, eats a balanced diet, sleeps well, exercises daily, and stays hydrated, they are still healthy. Don’t focus solely on the scale, focus on how you feel and function.”

So how can you get a better understanding of your health from home, without expensive equipment or lab work?

Here are the expert-backed tools Dr. Panduranga and Ghag recommend:

Waist circumference

“A tape measure is a simple and powerful tool,” says Dr. Panduranga. “High risk is above 40 inches (102 cm) in men and 35 inches (88 cm) in women. These ranges are even stricter for Southeast Asians.”

As WHO says, keep the waist circumference below 31.5 inches (80 cm) for females and 37 inches (94 cm) for males.”

Dr. Panduranga says this is even more predictive than BMI: “Your waist should be less than half your height," he says.

Body fat estimation tools

When it comes to measuring body fat at home, both experts suggest simple tools that don’t break the bank. Dr. Panduranga recommends starting with a bioelectrical impedance scale, the kind you can easily find online or at most pharmacies. “They offer a general idea of your body fat percentage and are accessible for everyday use,” he notes.

For a more detailed (and hands-on) approach, Sushma Ghag suggests using skinfold calipers. “Skinfold calipers can be used to measure body fat at home, but they require assistance,” she explains. “The 7-site method is typically used, and values are added to estimate body fat percentage.” In other words, measure fat in seven different spots on the body, and those numbers are added up to estimate your body fat percentage.

While calipers take a bit of practice, and another pair of hands, they’re a useful tool for tracking changes in body composition over time, especially if you're into strength training or focused on fat loss.

According to researchers at the UK’s Medical Research Council (MRC) Epidemiology Unit, waist circumference may be a stronger indicator of type 2 diabetes risk than BMI. Published in PLOS Medicine, the study found that waist size was strongly, and independently. linked to type 2 diabetes, even after factoring in BMI.

Study lead Dr. Claudia Langenberg and her team recommended that waist circumference should be routinely measured to better assess diabetes risk, especially since BMI alone may not reveal the full picture.

Their findings were striking: a man who is not classified as obese but has a waist circumference of at least 40.2 inches (102 cm) could have the same or even higher risk of developing type 2 diabetes as someone who is obese. For women, the same risk applies with a waist circumference of 34.6 inches (88 cm) or more.

Further supporting this, a separate study from the RAND Corporation found that waist size, not BMI—explained why the rate of type 2 diabetes is higher in the United States than in the UK.

Tracking your resting heart rate, blood pressure, and undergoing periodic blood tests (fasting glucose, lipid profile, liver function) can provide crucial early warnings about hidden health risks such as fatty liver or insulin resistance.

A new approach to health

The takeaway: BMI is just one piece of the puzzle, and not necessarily the most reliable one. Real health is defined by how your body functions, how you feel, and how your internal markers are performing—not just the number on a chart.

If you're active, eating well, sleeping soundly, and staying on top of your metabolic health, then you're likely on the right track—no matter what your BMI says.