BMI not accurate indicator of overall health - experts

Summary

• Health experts unanimously agree that BMI is not an accurate indicator of overall health and must also be viewed alongside other medical considerations.

• This comes after MACC Chief Commissioner Azam Baki announced last week that officers with BMI exceeding 27 would not be eligible for promotion starting next year.

Health and wellness experts unanimously agreed that Body Mass Index (BMI) should not be taken as an accurate indicator of overall health.

They said it must be considered within the context of other measurements such as blood markers, body fat percentage, and metabolic health indicators.

Malaysiakini reached out to several doctors and wellness professionals in response to MACC chief commissioner Azam Baki’s announcement last week that officers with a BMI exceeding 27 would not be eligible for promotions starting January 2026.

“It is laudable that there are efforts to improve health and fitness levels of staff members.

“However, using BMI as a cutoff point for promotions could be rather drastic, considering that a person with a higher BMI does not necessarily mean that they are not fit to work for the organisation,” said Dr Tee Ee Seong, a practising nutritionist and former Nutrition Society of Malaysia president.

Dr Fong Yeat Min, a general manager with third-party medical administrator PMCare, commended MACC for encouraging healthier lifestyles.

However, he said implementing a strict BMI-based policy for promotion could backfire, as it risks creating stigma and missed opportunities for capable and healthy individuals.

“Healthcare professionals recognise that BMI has value, but it is not without limitations.

“There is growing consensus in the medical community that BMI is an incomplete marker of health, as it does not distinguish between muscle and fat, nor does it account for fat distribution and metabolic function, all of which significantly influence disease risk.

“There are contexts (for specific careers) such as emergency services, armed forces, and high-risk operational roles, where a certain level of physical fitness is necessary, and BMI may serve as an early flag. But even in these settings, BMI alone is not sufficient,” he said.

BMI limitations

Fong further explained that the Malaysian Clinical Practice guidelines acknowledge the limitations of BMI and recommend that a healthy weight should be interpreted alongside waist circumference, metabolic parameters, and comorbid conditions.

“For career suitability, it’s more appropriate to apply fitness tests, strength assessments, cardiovascular endurance, and metabolic screenings.

“These better reflect whether someone can perform their job duties safely and effectively. In other words, BMI should initiate further assessment, not dictate final judgment,” said Fong.

Dr Nor Baizura Md Yusop from the Malaysian Society of Body Composition said it would be necessary to adopt a more holistic and comprehensive method beyond BMI to create meaningful and lasting change.

“With more than half of Malaysians currently overweight or obese, and significant rates of diabetes (one in six Malaysian adults), hypertension (one in three Malaysian adults), and high cholesterol (one in two Malaysian adults), promoting healthier lifestyles is a shared responsibility.

She said institutions like MACC can play a leadership role in this journey, not by singling out individuals, but by setting a positive example.

‘BMI mark can mislead’

Fitness coach K Kartik argued that while BMI gives a quick snapshot of weight category, it doesn’t consider muscle mass, fat distribution, or actual fitness, which can often be misleading.

“For instance, a bodybuilder’s BMI may describe them as overweight, but they’ve got more muscle than fat,” he said.

Kartik also echoed similar suggestions made by the doctors, who explained that holistic and non-punitive strategies would be more effective in encouraging healthier lifestyles.

These suggestions include implementing healthier menus at workplace cafeterias, improving access to nutrition counselling and fitness coaching, improving exercise facilities, and increasing support for mental and psychosocial health.

Dr T Darshini, a general practitioner and bodybuilder, also emphasised that the main goal for a healthier body is to achieve a sustainable balance index, instead of focusing on a sole parameter, such as BMI.

She said that individuals should aim for sustainable lifestyle changes, which can slowly help achieve one’s long-term goal, including practising mindful eating, knowing your daily calorie needs, and prioritising sufficient sleep.

“Changes do not happen in a relatively short period of time. It is good to encourage employees to take care of their health, but looking into it solely through BMI is not the best long-term approach.“

She said employers can implement health checks and fitness events that are beneficial for their employees and create an environment which is enjoyable and less stressful to ensure long-term sustainability and adherence.

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