BMI for South Asians: why 23 is the warning line, not 25
Many people in Pakistan and India are told their weight is "normal" because their BMI is under 25. But research shows that South Asians start to get diabetes and heart disease at a much lower BMI than Europeans. For us, the warning line comes earlier.
Quick answer
- BMI is your weight in kg divided by your height in metres, squared. It is a quick screening number, not a diagnosis.
- For Asian people, the WHO suggests extra caution from a BMI of 23 (increased risk) and 27.5 (high risk), instead of the usual 25 and 30.
- A large UK study found that a South Asian with a BMI of about 24 had the same diabetes risk as a white European with a BMI of 30.
- Check your waist size too. South Asians tend to store fat around the belly, which is the more dangerous kind.
What is BMI?
BMI stands for Body Mass Index. It is a simple number that compares your weight with your height:
BMI = weight (kg) ÷ height (m) ÷ height (m)
For example, a person who is 1.65 m tall (about 5 feet 5 inches) and weighs 68 kg has a BMI of 68 ÷ 1.65 ÷ 1.65 = 25.0. Our BMI calculator does this for you with simple sliders, in feet and inches or centimetres.
The usual cut-offs and the Asian cut-offs
| BMI | Standard (WHO, global) | For Asian people (WHO 2004 advice) |
|---|---|---|
| Below 18.5 | Underweight | Underweight |
| 18.5 to 22.9 | Healthy weight | Healthy weight, lowest risk |
| 23 to 24.9 | Healthy weight | Increased risk (overweight) |
| 25 to 27.4 | Overweight | Increased risk, treated as obese in Indian guidelines |
| 27.5 to 29.9 | Overweight | High risk |
| 30 and above | Obese | High risk |
In 2004, a WHO expert group looked at studies from across Asia. They kept the global categories, but advised that for Asian people, BMI 23 and 27.5 should be used as "action points" for public health. Indian national guidelines from 2009 go a step further and use 23 for overweight and 25 for obesity.
Why do South Asians have a lower cut-off?
At the same BMI, South Asian people on average have:
- More body fat and less muscle. Two people can weigh the same, but the South Asian person often has a higher body fat percentage.
- More fat around the belly and organs. This "visceral" fat sits around the liver, heart and gut, and is closely linked with diabetes and heart disease.
- Higher insulin resistance. The body needs to make more insulin to control blood sugar, even at a normal weight.
The result shows up clearly in the numbers. A study of 1.47 million people in England found that the BMI at which South Asians had the same risk of type 2 diabetes as white Europeans with a BMI of 30 was only about 23.9. That is why diabetes is so common in Pakistan, India and Bangladesh, even in people who do not look overweight. Pakistan now has one of the highest rates of diabetes in the world.
What does this mean for you?
Find your BMI with our BMI calculator, then use this simple guide:
- Under 18.5: You may be underweight. Read healthy weight gain for thin people, and see a doctor if you are losing weight without trying.
- 18.5 to 22.9: Great. Keep up healthy eating and activity, and check your waist size.
- 23 to 27.4: Time to take action. Losing even 3 to 5 percent of your weight (2 to 4 kg for most people) can lower your blood sugar and blood pressure. Get your blood sugar checked.
- 27.5 and above: Your risk of diabetes, high blood pressure and heart disease is high. Talk to a doctor, get your sugar, cholesterol and blood pressure checked, and start a weight loss plan. Our article how to lose weight on desi food is a good place to start.
What BMI cannot tell you
BMI is a quick, cheap screening tool, but it has limits:
- It does not see muscle. A very muscular person, like a wrestler or bodybuilder, can have a "high" BMI while being very fit.
- It does not show where your fat is. Belly fat matters more than fat on the hips and thighs. That is why waist size is so useful. See belly fat and waist size.
- It is for adults. Children and teenagers need special age charts.
- Older adults naturally lose muscle, so their BMI can look fine while body fat is high.
- Pregnant women should not use BMI to judge their current weight.
For a fuller picture, use BMI together with your waist size and our body fat calculator.
Health checks worth doing
If your BMI is 23 or more, especially if diabetes runs in your family, ask your doctor about:
- Fasting blood sugar or HbA1c test (for diabetes and prediabetes)
- Blood pressure check
- Cholesterol (lipid profile)
Many of these tests are cheap and widely available at local labs. Catching problems early makes them much easier to treat.
Common questions
What is a healthy BMI for Pakistani and Indian adults?
A BMI between 18.5 and 22.9 is the healthiest range for South Asian adults. From 23, health risks start to go up.
Is a BMI of 24 overweight for an Asian person?
By the global scale, 24 is "normal". But for South Asians, the WHO advises that 23 and above carries increased risk, and Indian guidelines call it overweight.
What BMI is obese for South Asians?
Indian guidelines use 25 and above for obesity. The WHO advice for Asian people marks 27.5 and above as high risk.
Is BMI different for men and women?
The cut-offs are the same for adult men and women. Women naturally have more body fat at the same BMI, which is why body fat and waist size are also useful.
Sources
- WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet, 2004;363:157-163. doi.org/10.1016/S0140-6736(03)15268-3
- Caleyachetty R, Barber TM, Mohammed NI, et al. Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: a population-based cohort study. The Lancet Diabetes & Endocrinology, 2021;9:419-426. doi.org/10.1016/S2213-8587(21)00088-7
- Misra A, Chowbey P, Makkar BM, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. Journal of the Association of Physicians of India, 2009;57:163-170.
- World Health Organization. Obesity: preventing and managing the global epidemic. WHO Technical Report Series 894, 2000.
- International Diabetes Federation. IDF Diabetes Atlas, 10th edition, 2021. diabetesatlas.org
- National Institute for Health and Care Excellence (NICE). Obesity: identification, assessment and management (CG189), BMI thresholds for people of South Asian background, updated 2023. www.nice.org.uk/guidance/cg189
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