BMI: Risks of being underweight & overweight

About BMI

The Body Mass Index (BMI), or Quetelet Index, is a measure of the human body shape, based on mass and height. To calculate BMI, divide the body mass by the square of his height. The result derived is in units of kg/m² or lb/in².

BMI calculation is easy and inexpensive. It is one of the best methods for assessment of Underweight, Overweight and Obesity conditions of the human body. It also serves as a screening tool to detect possible weight problems. It is a more accurate representation of body fat content in comparison to normal weight measurement.

BMI is not a diagnostic tool. It is valid only as a statistical category. It does not take into account certain factors such as pregnancy or bodybuilding. One has to undergo further assessments and health screenings for determining if the abnormal weight has health risks.

WHO regards a BMI of less than 18.5 as Underweight, greater than 25 as Overweight and above 30 as Obese. BMI results in between 18.5 to 25 are the most desirable.

Being Underweight

A BMI of less than 18.5 suggests that the person is Underweight.

The causes of being underweight include:

• Genetic Issues
• Metabolism Problems
• Lack of Availability of Food
• Side Effect of some Medical Conditions, such as Cancer, Tuberculosis, Hyperthyroidism, Anorexia Nervosa, Gastric Problems, Liver Problems and many more

Complications: Being underweight can lead to:

• Poor Physical Stamina
• Weak Immune System
• Anemia
• Hair Loss
• Amenorrhea, Infertility and Complication in Pregnancy in Women
• Osteoporosis

There are a few tried and tested ways to gain weight. Some of these include:

1. More Frequent Meals: Nutritionists recommend an intake of five to six smaller meals during the day instead of eating three large meals.
2. Intake of Nutritious Food: Nutritious foods and a healthy diet are of great help. The patient can opt for whole-grain breads, fruits, vegetables, nuts, seeds, lean protein sources, and low-fat dairy products.
3. Intake of Calorie-Dense Foods: Dry fruits, peanut butter, cheese, and avocados help gain weight. Smoothies and shakes made with low-fat milk or fresh juice are helpful too.
4. Regular Exercise: Regular exercise with weights helps in building muscles. Normal exercises stimulate appetite and increase the willingness to eat.

Being Overweight and Obese

A BMI of more than 25 suggests that the person is Overweight. Above 30 suggests Obesity.

Causes: The causes of being overweight and obese include:

• Alcoholism
• Hormonal Imbalances
• Eating Disorders
• Genetic Issues
• Insomnia
• Lack of Physical Activity & Exercises
• Overeating
• Poor Nutrition
• Metabolic Disorders
• Psychotropic Medication
• Smoking Cessation
• Withdrawal of Stimulants
• Stress
• Overdose of Insulin to treat Type 2 Diabetes

Complications: Being Overweight or Obese lead to many health problems and ailments.

Some of these include:

• Type 2 Diabetes
• High Blood Pressure or Hypertension
• Heart Diseases
• Cancer
• Stroke
• Sleep Apnea
• Osteoarthritis
• Fatty Liver Disease
• Kidney Disease
• Pregnancy Problems
• Abnormal Blood Fats
• Obesity Hypoventilation Syndrome
• Reproductive Problems and many more

To successfully lose weight it is important to make permanent changes in the diet and physical activity habits. The other treatment modalities include behavior change, prescription weight-loss medications, and Weight-Loss Surgery. We discuss each in detail below:

Changes to the Diet: A Healthy Eating Plan helps in losing weight and is ideal for weight management. The plan includes intake of healthy & nutritious food and avoiding high-calorie food. A healthy eating plan is low in Saturated Fat, Trans Fat, Cholesterol, Sodium, and added Sugar. It has the right amount of calories that are enough for the body. Women can safely lose weight with an intake of 1000 to 1200 calories a day. Intake of 1200 to 1600 calories a day helps most men to lose weight.

Regular Exercise and Activity: Various exercises, such as stretching, muscle strengthening, bone strengthening, weight lifting, aerobics and more help lose weight and to stay fit. Being physically active also helps lower the risk of various diseases and to manage stress.

Behavioral Change: A Behavior Adjustment Program helps in making lifestyle changes and losing weight. Guidance from support groups and counseling from professionals is of great help in this regard.

Medications: Physicians recommend medications for weight loss only if the above-mentioned methods have failed. They may also recommend medicines if the BMI is greater than 30, or if the patient's BMI is greater than 27 and he has medical complications, such as Diabetes, Sleep Apnea, Hypertension & more. These medicines work best when combined with a good diet, regular physical activity, and Behavioral Therapy. Medicines are unlikely to work on their own.

Weight-Loss Surgery: Medical practitioners recommend Weight-Loss Surgery or Bariatric Surgery, only if the BMI is greater than 40. In some cases they may recommend surgery if the BMI is in the range of 35 to 39.9, and the patient has weight related health ailments, such as Diabetes or High Blood Pressure.

The common weight-loss surgeries include Gastric Bypass Surgery, Laparoscopic Adjustable Gastric Banding (LAGB), Gastric Sleeve, and Biliopancreatic Diversion with Duodenal Switch. However, these surgeries do not guarantee removal of the entire excess weight permanently. The success of these surgeries also depends on the patient's commitment to make lifelong changes in his eating habits and physical activities.

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