Gurugram doctor: Normal BMI may not reflect metabolic health

A normal BMI can coexist with insulin resistance, high blood pressure, abnormal cholesterol or triglycerides, elevated blood sugar and fatty liver, said Dr Pankaj Khatana, senior consultant in internal medicine at Marengo Asia Hospitals, Gurugram.

“The important question is not only how much fat a person carries, but where it is stored,” he said. Visceral fat around abdominal organs and fat in the liver can affect insulin sensitivity and lipid levels, including in people who appear lean.

Physical inactivity, diet, poor sleep, smoking and excessive alcohol can contribute to metabolic problems regardless of body size. Genetics and age can also affect how the body stores and handles fat.

Dr Khatana said BMI should not be the only health marker. Waist circumference, blood pressure, fasting glucose or HbA1c, and a lipid profile can provide a broader view. A doctor may also advise liver tests or an assessment for fatty liver for some people.

He recommended regular exercise, a balanced diet, adequate sleep, and monitoring blood pressure, blood sugar and cholesterol. People concerned about their metabolic health should discuss appropriate screening with a doctor.