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The traditional way of assessing whether someone is overweight using body mass index (BMI) may fail to capture whether excess body fat is harmful and could be supplemented with a second measure when assessing patients, a new UCL study suggests.

In a study published in the International Journal of Obesity, the researchers used data from the 1970 British Cohort Study to see how nearly 7,000 46-year-olds compared in terms of their obesity levels according to both the traditional body mass index (BMI) (an adult's weight divided by their height squared) and the newer Lancet Commission on Clinical Obesity definition, which considers excess body fat alongside either tissue/organ functional impairment or substantial, age-adjusted limitations in daily living activities.

They found that about two-thirds (69%) of people classified as living with obesity (≥30 kg/m²) according to the BMI were not considered to have clinical obesity by the newer definition; by contrast, a smaller number (4%) who were considered a healthy weight by BMI thresholds showed signs of having clinical obesity.

Their study is the first to look at a wide group of people of a specific age, thereby ruling out factors that might be accounted for by age (such as that older people are naturally more likely to have organ damage).

The researchers are calling for clinicians and policymakers to consider "moving beyond BMI alone" when it comes to assessing the health implications of an individual's weight, arguing that the traditional BMI measure does not give the full picture—and can even be very misleading.

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