BMI has been the benchmark in evaluating health and fitness for many years. The formula is quite simple: weight in kilograms divided by the square of height in meters. This would easily tell if one is underweight, within the healthy weight range, overweight, or obese. But with new research findings, scientists are now questioning its accuracy and usefulness as a total measure of body composition.

The report, published in The Lancet Diabetes & Endocrinology, has sparked a global conversation on rethinking BMI. Supported by more than 50 international medical experts, the report suggests classifying obesity into "clinical" and "pre-clinical" types for better diagnosis and treatment. The shift underscores a growing consensus: BMI alone may not tell the full story of your health.

While BMI is simple to calculate and universally accessible, it is far from perfect. It does not consider muscle mass, bone density, or fat distribution, leading to misleading conclusions in some cases. For example, athletes with a high muscle mass may be considered overweight, whereas individuals with normal BMI might carry unhealthy amounts of visceral fat.

A landmark study in JAMA Network Open studied more than 155,000 postmenopausal women and found that women with a normal BMI but a waist size over 35 inches were more likely to die from heart disease or cancer compared with their counterparts whose waists are smaller. That makes a great case for how BMI can be insufficient and fat distribution must be factored into account.

Not all body fat is equal. Subcutaneous fat, which lies just beneath the skin, is relatively harmless. The real health danger lies in visceral fat—fat that surrounds internal organs. Unlike subcutaneous fat, visceral fat is metabolically active, releasing stress hormones like cortisol and inflammatory substances that raise blood pressure, blood sugar, and cholesterol levels. These effects significantly increase the risk of conditions such as heart disease, type 2 diabetes, and certain cancers.

BMI Isn't Always the Best Measure of Body Composition — Here's What to Use Instead

Since BMI is not the most reliable measure, scientists and doctors have sought other means to measure body composition more accurately.

1. Waist Circumference

A simple tape measure can provide valuable insight into your health. Measure your waist at the level of your belly button, ensuring the tape is parallel to the ground. For women, a waist measurement under 35 inches is considered healthy, while for men, the goal is under 40 inches.

2. Waist-to-Hip Ratio

This is the ratio of your waist circumference to that of your hips. To calculate it, divide your waist measurement by your hip measurement. According to the National Center for Biotechnology Information, a ratio under 0.8 for women and 0.9 for men is considered healthy.

3. Body Roundness Index (BRI)

A newer method that seems to be receiving more attention involves the Body Roundness Index or BRI: height, weight, and girth are placed together to represent a more advanced view of what body composition says. Research presented in JAMA Network Open offers evidence that this BRI predicts mortality risk greater than BMI in some cases- a promising weapon for public health.

Also Read: Using BMI To Classify People As Obese Is Flawed Say Experts

Ways To Cut Off Unhealthy Fat

The good news is that visceral fat responds well to lifestyle changes. Here are three evidence-based strategies:

Time-Restricted Eating

Adopting an eating window of 12 hours—such as from 7 a.m. to 7 p.m.—can significantly reduce visceral fat, according to a study published in Nutrition Research Reviews. This approach not only helps control caloric intake but also reduces late-night snacking, a known risk factor for abdominal obesity.

Limit Alcohol Intake

Excessive alcohol consumption is associated with increased belly fat. A 2017 study published in Public Health Nutrition revealed that alcohol increases the levels of insulin and encourages the storage of fat in the abdominal area. Limiting alcohol to occasional indulgence helps avoid weight gain in this region.

High-Intensity Interval Training (HIIT)

HIIT involves repeated episodes of high-intensity exercise separated by periods of rest. A review in *Sports Medicine* concluded that HIIT is very effective in reducing visceral and total body fat. It can be noted that adding just 20 minutes of HIIT two times a week can make all the difference.

The reliance on BMI as a sole indicator of health is increasingly being challenged. While it remains a convenient screening tool, its limitations necessitate a broader approach that considers factors like fat distribution, waist circumference, and new metrics such as BRI.

In the simplest of words, health is multi-dimensional, and shifting perspectives from considering weight solely to broader measures of body composition will get people a much clearer understanding of where their health risks are so that they can take the action required for a better quality of life. Through adjustment to diet, exercise, or perhaps through innovative metrics like BRI, health is well within reach of the individual.

This dynamic conversation raises the point about personalized health screenings, which helps everyone get more relevant tools fitting their unique lives and circumstances. As body composition research is enhanced, so do the futures look brighter and brighter for the times of measurement when it comes to health.

Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology.

Association of Normal-Weight Central Obesity With All-Cause and Cause-Specific Mortality Among Postmenopausal Women. JAMA Netw Open. 2019

Waist-Hip Ratio. NIH.

Physiological responses to food intake throughout the day. Nutr Res Rev. 2014

Association between abdominal obesity and alcohol drinking pattern in normal-weight, middle-aged adults. Public Health Nutr. 2017

High-intensity interval training (HIIT) has gained popularity among those who wish to achieve a good workout in a short amount of time. But for those with high blood pressure, the challenge is an important one: Can they attempt HIIT, or is it too much for the heart?

The answer, in short, lies with the individual. Having high blood pressure does not mean that a person has to avoid vigorous exercise, but the intensity has to be suitable considering the blood-pressure control and cardiovascular risk, fitness levels and other medical issues.

In India, where hypertension has become a growing public health concern, an ICMR-INDIAB study which looked at more than 113,000 people across the country, put the overall prevalence of high BP at 35.5 per cent among adults aged 20 years and above. It was higher among men and the urban population.

Blood-pressure control remains a concern in India as the WHO-India estimates that around 220 million people live with hypertension but only about 12 per cent have their BP under control.

So where does HIIT come in?

HIIT, which involves alternating short periods of high-intensity workout followed by recovery periods, can actually be beneficial. HIIT is not forbidden among those with high blood pressure, but the individual has to take stock of several factors before starting such exercises.

Those who are physically active, have good blood-pressure control, and no other concerns can probably take on HIIT workouts. But those who are sedentary and/or have poor blood-pressure control may have to work their way up. This is an important point to consider as HIIT might offer a good workout, but a hard-hitting workout is not always good for your blood pressure.

Also read: Heart Racing During Garba: Is It Adrenaline Or A Warning Sign?

Start with assessment, not max intensity

Among those who are new to exercise and have hypertension, jumping into an intense HIIT workout may not be the best move. A doctor would look at blood pressure, age, exercise history, cardiovascular risk and symptoms before advising on the most appropriate way forward.

A sedentary person should start with brisk walking, for example, before working their way up to cycling or jogging, and then adding higher intensity workouts, or interval training. It is about pace and control, and not going all out right at the start. Not only is that risky for those with hypertension, it could also lead to severe injuries.

Pay attention to exercises that help you warm up and cool down, and avoid stopping abruptly immediately after a vigorous round of exercise. While doing strength-based HIIT, people should avoid holding their breath, as this can cause blood pressure to spike. Make sure you train with a qualified trainer who can guide you through your workouts safely, and with the right advice.

Also read: Melissa McCarthy’s Weight Loss Mindset: Can It Help Break The Cycle Of Yo-Yo Dieting?

What about people with uncontrolled BP?

This is the point where exercising caution is important. People with high blood pressure who have persistently high or poorly controlled readings should not assume that every form of exercise is a good idea for them just because it is termed healthy.

Unexplained chest pain or discomfort, breathlessness or dizziness, fainting or unusual palpitations during exercise are signs that a person should stop their workout and get to a doctor rather than powering through the routine.

Those on antihypertensive medication will also need to take stock of their medication, how their blood pressure is behaving, and how their body is responding before deciding on the best approach to exercise.

The goal is sustainable cardiovascular fitness

For Indians looking to get into intense workouts, HIIT can be a part of a physically active lifestyle, but the aim should be cardiovascular fitness, not necessarily high-intensity workouts. Physical activity continues to be an important pillar in the management of blood pressure, alongside a balanced diet, weight control, adequate sleep, reduced salt intake, medication when needed and regular health check-ups.

So the right question for a person with hypertension is not: ‘Can I push myself as hard as possible’, but ‘What intensity is appropriate for my heart and blood pressure?’

By Dr. Debdatta Majumdar, Senior Consultant - Interventional Cardiology, Narayana RN Tagore Hospital, Mukundapur, Kolkata

Garba season is back, bringing hours of energetic dancing. While this aerobic activity naturally raises your heart rate, prolonged, high-intensity sessions can strain the cardiovascular system. In 2023, 10 people died within 24 hours while performing Garba.

So, how do you distinguish a normal exercise response from a warning sign?

Why Does Your Heart Race During Garba?

Dr. Anesh Jain, Cardiologist, Ruby Hall Clinic, Pune, told HealthandMe that two factors drive a faster heartbeat during Garba:

• Exercise: Working muscles need more oxygen, making the heart pump faster.
• Adrenaline: Loud music, excitement and crowds trigger adrenaline release, further increasing heart rate.

Also read: Weekend Workouts: Why Sudden Intense Exercise May Put Stress on Your Heart

When Is A Racing Heart Normal?

Dr. Nimit Shah, Consultant Interventional Cardiologist, Saifee Hospital, Mumbai, told HealthandMe that the heart beats faster during Garba to supply oxygen-rich blood to working muscles.

A normal exercise response typically involves:

• A steady increase in heart rate that matches the intensity of dancing.
• Breathing that settles with rest.
• A heartbeat that gradually slows after stopping.

However, a sudden or irregular heartbeat, or one that remains unusually fast despite rest, should not be ignored.

Warning Signs: When To Stop Dancing

Dr. Anesh advised stopping immediately if you experience:

• Unusual breathlessness: Struggling to speak or catch your breath.
• Chest discomfort: Pain, pressure or heaviness in the chest, arm, neck, shoulder or jaw.
• Dizziness: Feeling lightheaded or faint.
• Irregular palpitations: A pounding, skipping or erratic heartbeat.
• Persistent rapid heartbeat: A heart rate that does not settle with rest.

Chest pain, severe breathlessness or fainting requires emergency medical attention.

Read More: Strong Enough for HYROX, But Is Your Heart Fit Enough?

What Increases Heart Strain During Garba?

Several factors can increase the risk of complications:

• Dehydration: Heavy sweating causes fluid and electrolyte loss, potentially contributing to palpitations.
• Sudden intense exercise: Hours of vigorous dancing can strain the body, particularly in people unaccustomed to exercise.
• Low blood sugar: Fasting or inadequate food intake can cause weakness, dizziness and a rapid heartbeat.
• Excessive caffeine: Caffeine and energy drinks can trigger palpitations in some people.

“Prolonged dancing, dehydration, excessive sweating and inadequate food intake can put stress on the body,” Dr. Nimit said.

People with heart conditions, high blood pressure, diabetes or a history of abnormal heart rhythms should take extra precautions.

How To Protect Your Heart During Garba

Dr. Nimit recommended warming up, gradually increasing dance intensity, taking regular breaks and staying hydrated. Avoid prolonged dancing in hot, crowded venues.

Other precautions include:

• Eat adequately before dancing.
• Get enough sleep.
• Avoid excessive caffeine and energy drinks.
• Consult your doctor about safe exercise levels if you have a heart condition.

What To Do If Your Heart Starts Racing

If your heartbeat feels unusually fast or irregular:

• Stop dancing and move to a cooler, well-ventilated area.
• Rest in a comfortable, supported sitting position.
• Sip water if you are fully alert and can swallow normally.
• Seek medical help if symptoms persist. Call emergency services for chest pain, severe breathlessness or fainting.

Do not push through symptoms or rely on hydration and breathing exercises to manage possible cardiac warning signs.

The experts advised that Garba should be a celebration, not a test of endurance. Recognizing warning signs, taking breaks and respecting your limits can help you dance safely.

If you are trying to lose weight loss for a long time, it can become a cycle of strict diets, missed targets and constant frustration. Actor Melissa McCarthy says changing her relationship with weight, rather than constantly trying to control it, helped her approach the weight loss process differently.

In a recent interview with CBS Mornings, the Bridesmaids star reflected on how she stopped fixating on her weight. “I finally said [to myself], 'Oh, for God's sake, stop worrying about it,' and it may be the best thing I've ever done,” she said.

“I truly stopped worrying about [my weight]. I stopped over-analyzing, over-thinking, over-doing anything.” McCarthy added, “I just stopped constantly being worried about it, and I think there's something to kinda loosening up and not being so nervous and rigid about it that, bizarrely, has worked.”

McCarthy's weight loss mindset sheds light on a less restrictive, more sustainable approach can help people break the cycle of repeated dieting and weight regain, also known as yo-yo dieting.

Trapped In A Cycle Of Yo-Yo Dieting?

Also read: Strong Enough for HYROX, But Is Your Heart Fit Enough?

Yo-yo dieting, also known as weight cycling, refers to a constant process of repeatedly losing weight and regaining it. People may turn to restrictive diets for quick results, only to find that it is difficult to maintain over time and end up regaining all the lost weight.

Weight loss triggers certain changes in appetite and energy expenditure that can make maintaining the new weight challenging. Hunger may shoot up, while the body may expend less energy than expected, making regaining lost weight more likely.

Extremely restrictive eating plans can also be difficult to sustain alongside work, family responsibilities and social life. When a diet becomes too demanding, people may give up and return to previous eating patterns, sometimes interpreting weight regain as a personal failure rather than a sign that the approach was unsuitable for them.

McCarthy has previously spoken about moving away from extreme approaches. In a 2018 interview with The Breakfast Club, she said, “If I can de-stress and just do it slower and stop constantly trying to be on something.” She added that this approach “actually worked better instead of being like, ‘I'm gonna not do this and do this and only drink this.’”

She also said, “I'm just gonna mellow out, give myself a break.”

According to a few studies, yo-yo dieting has also been associated with health problems like changes in blood pressure and cholesterol. However, a 2024 review of 23 studies found that most available evidence did not show consistent adverse effects of weight cycling itself on body composition or resting metabolic rate.

A 2026 review published in The Lancet Diabetes & Endocrinology similarly concluded that current evidence does not strongly support a link between weight cycling itself and adverse changes in body weight, body composition or metabolic function.

This does not mean repeated weight loss and regain is irrelevant to health and overall fitness. It means the effects should not automatically be attributed to weight fluctuations alone, and people should not be discouraged from making another attempt at improving their health.

Mindset Shift Can Help Lose Weight Sustainably

A less rigid approach may make weight management more manageable by reducing the constant pressure. Setting realistic goals, maintaining eating patterns that can be maintained over time and allowing flexibility may help avoid the all-or-nothing thinking that often comes with extremely restrictive dieting.

However, McCarthy's personal experience does not prove that changing one's mindset alone causes weight loss or prevents weight regain. Weight management is influenced by genetics, hormones, medications, sleep, stress, environment and other factors.