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

Obesity is not just about how waist size or BMI, but it’s now reshaping the kinds of injuries patients are coming to orthopedic clinics. According to Dr. Rakesh Mattoo, Director of Orthopedics & Joint Replacement at Max Smart Super Speciality Hospital, Saket, the link between weight gain and joint degeneration is now impossible to ignore. “In India, cases of obesity-related osteoarthritis have increased by 30–35 percent over the last ten years, especially in urban areas,” he explains.

Orthopedic surgeons are seeing the consequences every day. “Approximately 55–60% of our knee replacement patients are now overweight or obese, up from about 35–40% a decade ago,” Dr. Mattoo shares. A similar pattern exists with hip replacements: obesity now accounts for nearly 28–30% of those cases, compared with 15% in 2010. The physics behind this trend are sobering, studies show that “every 5 kg of extra weight increases the load on the knees by approximately 15–20 kg,” accelerating cartilage wear and hastening surgical intervention.

What Is Happening In India?

These clinical numbers reflect a far larger population trend. India’s burden of obesity has been rising steadily for decades. In 2022, around 70 million adults in India were classified as obese, including 44 million women and 26 million men, according to data published in The Lancet. This marks a sharp rise from the early 1990s, when obesity rates were much lower. Overall, obesity prevalence climbed from 1.2% to 9.8% in women and 0.5% to 5.4% in men between 1990 and 2022. Additionally, overweight and obesity together affect nearly one in four Indian adults, nearly 24% of women and 23% of men aged 15–49, and even children are showing increases in overweight prevalence.

It’s not just body weight that matters, but where fat is stored. Central abdominal fat, that stubborn belly, is one of the greatest predictors of early joint degeneration, says Dr. Mattoo. And certain groups are at especially high risk: women (particularly post-menopausal), people with prior knee injuries, those with family histories of osteoarthritis, and individuals leading sedentary lives. Conditions like diabetes, hypothyroidism, and metabolic syndrome also create a kind of chronic internal inflammation that accelerates cartilage breakdown.

How Can You Stay Safe?

So what can someone do to protect their joints before they reach the operating table? Dr. Mattoo emphasizes realistic, sustainable steps:

Keep weight in check: Even losing 5–10% of body weight can significantly ease stress on knees and slow osteoarthritis progression.

Build strength: Strengthening the muscles around the thigh, hip, and knee, along with the core, helps distribute load and protect joints. Moderate, low-impact activities like walking, cycling, or swimming are far kinder to joints than high-impact exercise.

Eat smart: “Choose joint-friendly nutrition,” he urges, including foods rich in omega-3s, calcium, vitamin D, and protein, all essential for healthy muscle and cartilage.

Don’t rush into high-impact activity: Running, jumping, or poorly executed gym movements may feel energizing but can do more harm than good if your body isn’t prepared.

Get routine screening: Annual check-ups — including BMI, vitamin D levels, blood glucose, and lipid profiles — catch early risk factors so that preventive measures can be taken.

Looking at younger adults, building strong musculature between ages 20–35 isn’t vanity — it’s protection. Dr. Mattoo points out that muscle mass helps slow degenerative joint changes over decades. Simple habits like walking 6,000–10,000 steps a day, practicing correct posture, and avoiding harmful sitting patterns or lifting techniques go a long way.

With air pollution keeping many indoors, lifestyle changes have to adapt. Structured home workouts like resistance bands, yoga, or bodyweight exercises can mimic outdoor benefits. Even small changes — standing desks, walk-and-talk phone calls, frequent stretch breaks — increase daily calorie burn and reduce sedentary strain.

The rising tide of obesity isn’t just a statistic; it’s now manifesting in the everyday pain and movement limitations of millions of Indians. But as Dr. Mattoo reminds us, “It’s never too early or too late to make changes that protect your joints and your future mobility.”

Aging brings a shift in how the body functions. Metabolism slows down, hormones fluctuate, and the risk of conditions such as diabetes, heart disease, joint problems, and bone loss begins to rise. Health experts often describe the 40s as a turning point, a decade where prevention matters more than ever. According to US-based longevity doctor Dr Vassily Eliopoulos, many habits that feel harmless in one’s 20s and 30s begin to show their impact sharply after the age of 40.

In a recent Instagram post, Dr Eliopoulos highlighted five things people should stop doing immediately if they want to protect their long-term health. He wrote that this is the decade to take muscle health seriously, make sleep a priority, and let go of small daily habits that quietly speed up aging. He added that the choices made in the 40s decide how well the body functions in the 50s, 60s, and 70s because preventing damage is always easier than trying to repair it later.

Stop cutting back on sleep

Sleep becomes crucial in the 40s because the body needs more time to repair itself. Dr Eliopoulos explains that adults between 40 and 60 require seven to nine hours of sleep every night to maintain hormone balance, protect cognitive function, and support metabolism. Even losing a single hour can make a difference. Research shows the risk of type 2 diabetes, heart disease, and faster brain aging rises for every hour of sleep below the seven-hour mark. Chronic lack of sleep also encourages fat storage around the abdomen, weakens the immune system, and slows recovery after daily activities.

Simple habits such as keeping the room dark and cool, avoiding late-night screen time, and sticking to a regular sleep schedule can make sleep more restorative. Dr Eliopoulos describes good sleep as a free nightly hormone reset.

Stop neglecting strength training

Muscle loss is one of the most predictable changes after 40. According to Dr Eliopoulos, adults lose three to eight percent of their muscle mass each decade unless they actively work against it. Resistance training two to four times a week can slow this decline dramatically.

Strength work helps maintain bone density, improves insulin sensitivity, and builds lean muscle. Exercises such as squats, push-ups, weightlifting, or using resistance bands increase stability, balance, and overall metabolic rate. Studies also show that middle-aged adults build strength more efficiently with resistance training than relying on cardio alone.

Stop relying on highly processed foods

Packaged snacks, sugary drinks, instant meals, and ultra-processed foods can have a much bigger impact in midlife. More than half of adults over 40 struggle with obesity linked to these foods. They cause sudden spikes in blood sugar and promote inflammation, raising the risk of heart failure. These foods also lack fibre, which affects gut health and increases the risk of colon cancer. Brain health is not spared either, with several studies linking diets high in processed food to faster cognitive decline.

Switching to whole foods such as fruit, nuts, vegetables, and yoghurt can help stabilise energy levels and reduce the risk of diabetes. Reading labels to avoid additives and hidden sugars is an important habit at this stage.

Stop delaying routine health tests

Once a person enters their 40s, regular health screenings become essential. Many conditions, including high cholesterol, prediabetes, thyroid disorders, and vitamin deficiencies, develop silently. Monitoring levels such as A1C, lipid profiles, thyroid markers, and vitamin D helps detect issues early, allowing interventions before symptoms show up. Avoiding tests often means missing warning signs until fatigue, pain, or more serious complications appear.

Stop letting stress build up

Stress hits harder in the 40s because the body becomes more sensitive to cortisol. Continuous stress can raise blood pressure, increase inflammation, affect memory, and contribute to anxiety. Long-term stress even accelerates cellular aging and can push biological age forward by several years. When paired with poor sleep or unhealthy eating, stress significantly increases the risk of stroke.

Dr Eliopoulos recommends daily breathing exercises, regular walks, and simple meditation practices to help reduce stress and protect long-term health.

Disclaimer: Please note that this is a user-generated content. Health and Me does not encourage any changes to be made in your daily schedule without consulting your doctor.

A New York City teacher Pedro Soto, 56, who teachers at the Manhattan school had a simple sore throat and he believed it was from a viral infection, but it soon turned out to be type 2 diabetes.

This was in April 2024, when he went to his doctor with the complaint of a sore throat and took a blood test. This is when he was "officially diagnosed with type 2 diabetes".

In an interview with PEOPLE, he tells while the doctor recommended medications for him, he was determined to make a lifestyle change first. "After receiving the news, I chose not to start medication right away. Instead, I committed to exercising, running twice a week and improving my diet."

Turns out, running, changed his life.

Running With Diabetes: Soto's Determination To Change His Life(style)

Pedro Soto first considered running the TCS NYC Marathon after a colleague mentioned that her husband had completed it. Motivated, he applied through a special program for teachers, sharing an essay about his type 2 diabetes diagnosis. His story earned him a spot on the team. As he trained, he closely monitored his health, undergoing regular blood tests every three months. The improvement surprised him. His blood sugar levels, once concerning, gradually returned to the normal range. While type 2 diabetes cannot be fully cured, it can be reversed, and Soto was seeing that transformation firsthand.

Training Through The Tough Times

The marathon was scheduled for November 2, 2025. Soto’s training, however, didn’t begin smoothly. In June, he learned he had Lyme disease. Around the same time, he lost his father. Because of these back-to-back challenges, he wasn't able to train consistently until August. Running soon became more than exercise. It became a way to navigate grief and rebuild strength.

He describes those months as emotionally heavy. Running offered him space to reflect, heal, and feel close to his father. It became a ritual that allowed him to confront his feelings rather than avoid them.

Experiencing the Race

To prepare mentally, Soto dove into YouTube videos and articles about the marathon. Still, nothing compared to the real thing. To him, race day felt like a citywide block party. The cheering crowds, music, and energy made the pain more bearable. He said that although the long hours of pounding take a toll on joints and muscles, the city's encouragement kept pushing him forward.

Finding Strength in His Students

The toughest stretch came in the final six miles, when self-doubt crept in. What kept him going was thinking about his students. Soto works with teenagers in a transfer program, many of whom have struggled in traditional school systems. Their perseverance inspired him. If his students could show up every day despite their challenges, he believed he could finish the race.

He says he is taking care of his health and this itself is an act of commitment to his students. Whenever he feels healthier, he shows up as a strong educator and for him the marathon teaches him the importance one needs in life of balance, self-care, and knowing when to put themselves first.