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YouTubeBMI Cut-Offs by WHO: In 1997, a WHO expert committee defined BMI cutoffs. These cut-offs are used by many countries, including CDC in USA.
WHO-defined BMI Cut-offsUnderweight: BMI < 18.5
Normal: 18.5 ≤ BMI < 25
Overweight: 25 ≤ BMI < 30
Obese: BMI is 30 or higher
India-Specific BMI Cut-Offs: In 2009, consensus guidelines were developed by a Prevention and Management of Obesity and Metabolic Syndrome group in India:
India-Specific BMI Cut-offsNormal: 18 ≤ BMI < 23
Overweight: 23 ≤ BMI < 25
Obese: BMI is 25 or higher
Wow! This means that somebody from India with BMI in range 25 to 30 would be overweight by WHO-defined BMI cut-offs used in USA, but obese by India-specific cut-offs. For details, see Obesity Among Indian Americans.
India-specific BMI cut-offs are not widely known! If we are from India, we really need low BMI to minimize our risk of various diseases linked to obesity!
WHO recognizes that people all over the world are different! So they leave it to regions to chalk out region-specific guidelines. Why may Asian populations need region-specific BMI cut-offs? Due to higher prevalence of diabetes and cardiovascular diseases even at lower BMI. For example, this paper from Lancet Global Health (2018) says:
Screen at 23 Program: In 2015, recognition of such concerns led to the Screen at 23 Program being rolled out in states like Hawaii, California, Massachussestts, Illinois and Washington; these are US states with significant South Asian populations. What's the Screen At 23 Program? In USA, diabetes screening is done if BMI ≥ 25. However, for South Asians, the threshold for diabetes screening is being lowered to BMI ≥ 23.
- (2017) Obesity in adult Asian Indians - the ideal BMI cut-off by Mahajan & Batra is a well written 1-page letter to the editor that summarizes what's going on. Worth reading.
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(2009) Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management by many authors, JAPI (J Association of Physicians of India), Vol 57, 2009.
This is the paper where 100+ medical experts in India were consulted to define BMI thresholds for Indians.
- Obesity Among Indians (CADI Research article) proposes the same cutoffs and has interesting obesity-related tidbits of information. CADI Research is headed by Dr Enas, a world expert on cardiac disease among Indians. Also see Obesity In Indian Americans (CADI Research article).
- (2014) Implications of the Revised Consensus Body Mass Indices for Asian Indians on Clinical Obstetric Practice by Aziz, Kallur & Nirmalan, J Clin Diagn Res, 8(5), May 2014. It says, "The prevalence of obesity [in pregnant women in a tertiary perinatal center in Hyderabad, India from 2010 to 2012] increased from 11.81% with the WHO criteria to 43.11% with the revised consensus guidelines" [Whoa!]
- Wikipedia article: Obesity in India mentions the India-specific BMI cut-offs.
(2014) Indians with BMI of 23 should start worrying: doctors, Hindustan Times.
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