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

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.

HYROX has suddenly become a fresh fitness challenge for anyone willing to test the limits of their strength and endurance. The typical gym session will soon be swapped out with a HYROX race, a hybrid of running and brutal functional fitness movements that have you shifting constantly between cardio and muscular efforts.

Being able to lift heavy weight, run for kilometers, or knock out the crazy gym session doesn't guarantee the heart is ready to match that level of high-intensity work. An individual having great strength and endurance doesn't guarantee he/she has a healthy heart.

The significance of this difference is that cardiovascular disease is still a huge problem. According to the WHO, as many as 19.8 million people died from cardiovascular diseases worldwide in 2022, representing approximately 32% of all deaths. In India, the disease is also a significant cause of death; WHO states that 27% of deaths in India are caused due to CVDs, and it is estimated that around 220 million people in India suffer from high blood pressure.

It does not mean that people should be scared of hard exercise. Exercise is a vital component of heart health. The question is, is the individual adequately prepared for the intensity of effort they are undertaking?

Prioritizing heart before HYROX: When?

Also read: Is 'Hyrox' Challenge Worth The Hype Or Just Another Fitness Trend?

People who are starting a program of vigorous exercise should be familiar with the symptoms of distant chest pain, abnormal breathlessness, fainting or dizziness, palpitations or irregular heartbeats, or abrupt decrease in exercise capacity.

If you have a personal or family history of early cardiac disease, known hypertension, diabetes, high cholesterol, smoking, obesity or prior cardiac disease, it would also be worth discussing with your physician prior to high intensity training. Most importantly, we emphasise that there is no universal cardiac screening test that every participant of HYROX requires. Cardiovascular screening should be risk stratified and individualized.

Sometimes just taking your blood pressure and examining you will be sufficient. A doctor might choose to do additional tests – eg, an ECG or exercise stress test – if you have symptoms and/or risk factors and/or other diseases, especially if you are 40 years or older. Additional tests may also include images of your heart.

Risk Assessment Before Exercise

The European Society of Cardiology's sports-cardiology guidance recommends on risk determination before strenuous physical activity, but not on the use of the same testing algorithm for all. An evaluation with a clinical assessment, ECG, and exercise testing may be recommended for adults who are not physically active or have a high cardiovascular risk for a planned high-intensity exercise.

Don't confuse fitness with cardiovascular clearance One may have very strong muscle and not be aware that he or she has an unrecognized risk factor for cardiac health. Alternatively, a person with a known cardiac condition may safely perform a monitored exercise program with appropriate testing and management. The goal is not to keep you from any additional HYROX or heavy training, but only to Know what your heart is capable of and your risk factors, warning signs and symptoms.

Strength is one element of fitness. But before you question whether you have enough strength to finish the next workout, here's a question for you: Is your cardio ready?

By Dr. Rajat Kar, Consultant - Adult Cardiology, Narayana Hospital, Howrah

Weight loss from GLP-1 drugs like Ozempic may also result in some muscle loss, not just fat. Researchers are, therefore, testing whether a second drug could help protect muscle while people lose weight.

According to new trial data, an experimental drug developed by Regeneron called trevogrumab reduced muscle loss when it was taken along with Novo Nordisk's semaglutide, the active ingredient in Ozempic and Wegovy.

It could be a significant development in the GLP-1 weight loss drugs market as researchers are focusing on what kind of weight people are losing rather than how much.

Ozempic Results In Muscle Loss

Ozempic contains semaglutide, a GLP-1 drug that helps lower blood sugar and reduce appetite. As people eat less consistently and lose weight, the body can lose both fat mass and lean mass, which includes muscle.

Reuters reported researchers found that patients who took semaglutide lost 6.7% of their lean muscle mass over 26 weeks in one part of the trial.

This also does not mean that everyone on Ozempic will lose a large amount of muscle. Diet, physical activity, protein intake, age and starting muscle mass can all influence body composition during this weight loss.

But preserving muscle is crucial, especially for older adults and people who already have low muscle mass.

Also read: 2 Indians Charged In US Over Fake Ozempic Scheme: How To Spot Counterfeit GLP-1 Drugs

Could Trevogrumab Help?

Trevogrumab, developed by Regeneron, belongs to a class of drugs that targets myostatin, a protein involved in regulating muscle growth and maintenance.

While semaglutide helps drive weight loss, trevogrumab may help prevent the body from breaking down as much muscle during that process.

In the trial, people who received semaglutide alone lost 6.7% of their lean muscle mass over 26 weeks. Those who received semaglutide along with 75 mg of trevogrumab lost 3.3%, while the group receiving 25 mg lost 4.7%.

That means the higher dose nearly halved the lean-mass loss seen with semaglutide alone.

Also read: 21% In 80 Weeks: Lancet Study Finds Lilly’s Retatrutide Delivers One Of The Biggest Weight Losses Ever

More About The Trial & Trevogrumab

The drug is experimental and has not been approved as a treatment for people taking GLP-1 drugs.

The trial involved nearly 1,000 people aged 18 to 65, and the researchers are continuing to study trevogrumab. Regeneron has selected the 75 mg once-weekly dose for further studies and plans another mid-stage trial involving people over 65.

The larger trial initially included another experimental drug, garetosmab. Two people receiving higher-dose trevogrumab in combination with garetosmab died during the first 26 weeks.

One death had an undetermined cause in a person with multiple cardiovascular risk factors, while the other was due to cardiac arrest in someone with a history of cardiovascular disease. Regeneron said it will not continue developing the triple-drug combination.

Maintaining Muscle Mass During Weight Loss

Muscle is important for strength, mobility, balance and everyday physical function. Losing too much muscle during rapid weight loss could be particularly concerning for older adults, who are already at risk of age-related muscle loss.

This is why the next generation of obesity treatments may focus on more than the number on the weighing scale.

Regeneron executive Boaz Hirshberg said, “What we want to do is concentrate on the quality of weight reduction. We want to find the best way to approach weight reduction, especially in vulnerable patients.”