Body Mass Index After Menopause - Fact or Fallacy?

Measuring Weight After Menopause : Is it the Right Number?
       During and after menopause, many women note changes in their metabolism, fat distribution, and body shape.  Typically, the changes involve increasing weight and body fat, increased abdominal circumference, and a reduction in lean body mass.  Many times, their BMI will be normal or “pre-obese” but their body fat will be in the obese category and their will be adverse metabolic characteristic such as high cholesterol or pre diabetes. 
     This article asks the question of whether the BMI is the appropriate tool to measure obesity in postmenopausal women.  It measures the BMI in 1,329 postmenopausal women and compares the obesity classification to that determined by DEXA scan, a gold standard for measuring body fat. This is the same DEXA scan that measures a body density but has an extra feature that measures adipose tissue as well.  The results were convincing: only 32.4% of women who were obese by a body fat percentage of 35% and above were correctly classified as obese by BMI. At 38% body fat,  for 35% body fat, 44.6% were correctly classified, and at 40% body fat, 55.2% were correctly classified.  Moreover, the study found that in post-menopausal women, the empirical optimal BMI cut-point to define obesity is 24.9 kg/m2!
       What does this mean?  Well, many patients come to Rainier Medical having gone through menopause saying that their clothes are not fitting them, and while they do not have “that much weight to lose”, their body looks and feels very differently.  We will typically use a modified low calorie diet, which utilizes high protein fortified medical foods with essential fatty acids, some carbohydrates, as well as 100% of the recommended daily allowance of micronutrients, with one grocery store meal a day with an exercise program of resistance exercise to effect a change in body composition and metabolic health above and beyond “weight loss.”  The goal is to increase skeletal  muscle mass and increase metabolic rate and decrease body fat.  This differs from a simple weight loss program in which more weight is lost, but typically lean body mass and metabolic rate decrease and body fat percentage stays the same.  The difference in the end result is that with the latter, calorie intake in maintenance needs to be lower and with our programs, the goal is to avoid frailty with further aging, including osteoporosis.  There is an example of a result on our website here, entitled “Body Comp:”  Interstingly, Medicare will only cover preventive counseling for obesity if your BMI is over 30!  Another example of how insurance dictates the healthcare you may receive, instead of your physician. 

     Do you wonder about your own body composition?  Contact us to see how you can get yours measured at

    Questions or Comments?  Post them here:

                                              Free Registration required here:






Leave a Comment

No User Photo