Bariatrics and Weight Loss

Beyond BMI and the number on the scale

Beyond BMI and the Number on the Scale


By Dr. Stephanie Page, Medical Director for the Metabolic Weight Loss Program at Danbury Hospital

Body Mass Index (BMI) measures a person’s weight in kilograms/square inch of height in meters.

It’s used to screen for weight categories and can be an indicator of increased levels of fat tissue, including risks for metabolic diseases like diabetes mellitus, fatty liver disease and hypertension.

  • Underweight: BMI < 18
  • Normal: BMI 18-25
  • Overweight: BMI 25- 29.9
  • Class 1 Obesity: BMI 30 - 34.9
  • Class 2 Obesity: BMI 35- 39.9
  • Class 3 Obesity: BMI > 40

Considerations for BMI

Although BMI can be used to assess risk factors for individuals carrying extra weight, it is not a one-size-fits-all measure to set weight loss goals or determine a healthy weight.

This may play a role in indications of what is considered being classified in the obesity or overweight range.

  • Example: Individuals of Asian descent have a lower weight threshold to relative to what is considered overweight or obesity. In contrast, recent research is indicating people of African American descent may have a higher weight threshold relative to being in the overweight/obesity range.  

Athletes and those with higher muscle mass can often carry a higher weight on the scale because muscle is of higher density than fat.

  • Example: If you have significant muscle mass, you may have a higher BMI. Please note, this does not mean you have an unhealthy weight!

What is body composition?

Body composition is the composition of your total body mass specific to fat mass (body fat) and fat-free mass (muscle, bone, connective tissue, organs, water).

Why is it important?

Having adequate muscle mass is crucial to building metabolic health because increased muscle keeps bones strong, serves as a healthy reservoir for fuel (specifically glucose/sugar) and helps maintain high metabolic rate.

Ideal body fat percentage:

  • Men: < 25 percent
  • Women: < 32 percent

How do you measure it?

The Metabolic Medical Weight Loss Program uses advanced body composition technology to provide highly accurate composition assessments.

Tracking measurements

If you do not have access to a body composition scale, measuring your waist circumference is another way to track your health progress. Carrying more weight in your mid-section (abdomen) may pose a higher risk for metabolic diseases like Type 2 diabetes and high blood pressure (hypertension). 

  • Example: Visit the Centers for Disease Control and Prevention website to learn how to accurately measure your waist circumference. 
  • A healthy waist circumference for women is < 35 inches (< 30 inches for women of Asian descent)
  • A healthy waist circumference for men is < 40 inches (< 35 inches for men of Asian descent) 


The bottom line

There is more to just the number on the scale!

Take charge of your health and speak to your primary care or specialist clinician about what is a healthy weight for you.

When setting weight loss goals, be sure to also track your waist circumference and set an initial 5-10 percent weight loss goal, which can help you reach success for your metabolic and overall health goals.