Why BMI alone doesn’t tell the whole story for Indian patients
Updated: Oct 1
What BMI does well
BMI is simply weight in kilograms divided by height in metres squared. It is inexpensive, reproducible and useful for identifying population-level risk.
It remains part of obesity assessment because it provides a common starting point.
What BMI cannot tell you
BMI does not distinguish fat mass from muscle mass. It also does not show where body fat is stored. Two people with the same BMI can have very different waist circumference, visceral fat and metabolic risk. This is particularly important when looking at central or abdominal adiposity.
Why this matters in India
Indian and other South Asian populations are recognised as having higher cardiometabolic risk at comparatively lower BMI levels. The Endocrine Society of India therefore uses India-specific thresholds and emphasises complications as part of clinical assessment.
This does not mean every Indian patient with a lower BMI has metabolic disease. It means clinicians should avoid using a single number as the entire assessment.
What else should be measured?
Depending on the patient, useful measures can include waist circumference, blood pressure, fasting glucose or HbA1c, lipid profile and assessment for obesity-associated conditions such as fatty liver disease or sleep apnoea.
Family history, medications, sleep, physical activity and weight trajectory can add further context.
The practical takeaway
If your BMI is the only thing anyone asks before recommending treatment, the assessment is incomplete. Good obesity care asks a broader question: what is this person's current health risk, and what intervention is proportionate to that risk?
References
Endocrine Society of India. Clinical Practice Guidelines for the Evaluation and Management of Obesity in India: 2025 Update. PubMed Central (PMC)
Chiu M, et al. Deriving ethnic-specific BMI cutoff points for assessing diabetes risk. Diabetes Care. 2011. This is the study supporting the approximately BMI 24 vs BMI 30 diabetes-risk comparison. PubMed
Ross R, et al. Waist circumference as a vital sign in clinical practice. Nature Reviews Endocrinology. 2020. PubMed
Ntuk UE, et al. Ethnic-specific obesity cutoffs for diabetes risk: cross-sectional study of 490,288 UK Biobank participants. Diabetes Care. 2014.
Written and clinically reviewed by: Dr Saran Seker, MBBS (Aus), Chief Medical Officer
Last reviewed: September 2026
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