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Weight and well-being, beyond BMI

Your health is much more than your body mass index

By Gunardi Irawan, M.D., internal medicine, The Portland Clinic-Beaverton.

Happy New Year! If this time of year motivates you to take a fresh look at your health and weight, The Portland Clinic’s weight-management team is here to help. As specialists in this field of medicine, we’re excited to provide expertise, tools, and support to help guide you toward better health, beyond BMI.

Your health is more complex than a number

BMI, or body mass index, is a measure of your weight relative to your height. Developed by a mathematician in the 19th century, it has evolved into a widely used tool to identify risks associated with low and high weight. But is it a complete picture of your health? Absolutely not.

The World Health Organization generally designates a BMI of less than 18.5 as underweight; 18.5 to 24.9 as healthy weight; 25 to 30 as overweight, and 30 or above as obesity. But these numbers and labels have limitations.

First, the labels themselves can be discouraging and stigmatizing. It’s important to know: your BMI may suggest that you have overweight or obesity, but not that you are them. These are health conditions. They are not you.

Second, the numbers aren’t perfect. Since muscle weighs more than fat, an athlete might have a higher BMI than an older, sedentary adult. BMI benchmarks also don’t apply universally to all ethnicities. In Asian populations, for instance, health risks can arise at a lower BMI, so a BMI over 23 may signal overweight.

In assessing your health, BMI offers a convenient initial snapshot, but it’s not the whole picture. Your health narrative is more complex than a number

How do we take a more complex picture?

Our weight-management team supplements BMI with other measurements, such as waist circumference and body fat percentage, plus a comprehensive review of your medical history. This reveals a more thorough understanding of your body composition and helps identify risks that BMI alone may overlook.

Approaching weight management from five angles

Losing 5-10% of your body weight can significantly improve conditions like diabetes and hypertension. But as we partner with you, our focus is not just on the scale. It’s on your overall well-being, including your feelings, your body’s functionality, and your relationship with food. Our weight-management team takes a five-pronged approach to supporting your health and goals:

  1. Treating underlying medical causes. If you struggle to manage your weight, underlying medical conditions may be working against you. Low thyroid levels, sleep apnea, stress, insulin resistance, and many medications can increase weight or make it harder to lose. Identifying and treating these is key.
  2. Personalized Nutrition plans. The most successful eating plan is one that’s tailored to you — your food preferences, health history, previous experiences, and what you’ll be most willing and able to maintain for life.
  3. Exercise recommendations. Exercise improves many conditions that lead to weight gain, and helps you avoid regaining the weight that you lose. We guide you toward activities that are in sync with your capacities and preferences.
  4. Behavioral changes. Our team supports you in making changes that help you cultivate a healthier relationship with food, physical activity and your body.
  5. Weight-loss medications. Today’s medication advances are helping many people to finally break through lifelong barriers to weight loss. There are many options, and we can help you explore whether they’re appropriate for you.

As a member of the dedicated weight-management team, alongside Ann Paulsen, M.D., and Amanda Tobias, Pharm.D., I stand ready to help you look beyond the scale and embrace a comprehensive approach to health.