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    Home ยป Learn About Paleo & Keto Diets

    All About Body Fat Percentage

    Last Modified: Feb 9, 2023 by Paleo Leaper ยท This post may contain affiliate links ยท Leave a Comment

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    If you want to know whether or not someone is at a โ€œhealthy weight,โ€ the first thing youโ€™d typically ask for is their BMI, or Body Mass Index. BMI basically measures the ratio of your weight to your height, so it accounts for the fact that a 5โ€™1โ€ person could be perfectly healthy at 110 pounds, while a 6โ€™1โ€ person would be dangerously underweight at that same number.

    When people use BMI as a measurement of a โ€œhealthy weight,โ€ what theyโ€™re really measuring is a โ€œhealthy fatness:โ€ itโ€™s not weight per se that causes health problems, so much as too much or too little fat tissue. Fat is a metabolically active organ; too little and we die or start having very severe health problems, but too much and we start being susceptible to chronic inflammation, insulin resistance, and other health problems. The assumption behind using BMI to measure health is that most people at a given weight have a relatively similar amount of bone and muscle and organ mass, so BMI is largely measuring variations in adipose tissue, or body fat.

    The Problem with BMI

    This person could be obese on the inside - you can't tell just by looking or even by measuring his weight.

    On a population level, where individual variations balance each other out, BMI is a useful tool. But an increasing amount of research into body composition suggests that BMI isn't great for measuring the health of individual people.

    Everyoneโ€™s heard of the professional athletes who are โ€œobeseโ€ or โ€œoverweightโ€ by BMI even though theyโ€™re lean, fit and extremely healthy: they just have a larger-than-average amount of muscle mass, and BMI doesnโ€™t distinguish between muscle and fat. These athletes are very unlikely to be struggling with the health problems of obesity.

    Most of us donโ€™t have enough muscle mass to tip us into โ€œobeseโ€ or even โ€œoverweight but whatโ€™s more common is the other end of the scale: people with a โ€œnormalโ€ BMI who are overfat โ€“ who may not even realize they have a problem, because their BMI is normal so nobody thinks to check.

    This study found that around 11% of Italian subjects were obese by body fat percentage despite being โ€œnormalโ€ by BMI. Normal-weight obesity was more common in women than in men, but it was found in both. This study found even worse numbers: about half of โ€œnormal-weightโ€ US adults had obesity by body fat percentage. And that number may be higher in other ethnic groups โ€“ for example, Asians typically have a higher body fat percentage at a given BMI.

    This is called normal-weight obesity (NWO). Normal-weight obese people are more likely to have cardiovascular problems, systemic inflammation, and other health problems. Many people with normal-weight obesity have full-blown metabolic syndrome; theyโ€™re classified as Metabolically Obese Normal Weight (MONW), and thatโ€™s even worse:

    โ€œthe prevalence of the MONW syndrome ranges between 5% and 45%, depending on the criteria used, age, BMI, and ethnicityโ€ฆ when compared with control subjects, MONW subjects display an altered insulin sensitivity, a higher abdominal and visceral adiposity, a more atherogenic lipid profile, a higher blood pressure, and a lower physical activity energy expenditureโ€ฆMONW subjects are at higher risks for type 2 diabetes and cardiovascular diseases.โ€

    For their health, these people need the same interventions as people with obesity and metabolic syndrome, but theyโ€™re unlikely to get the help they need because their BMI is โ€œnormal.โ€ You can only see the problem once you look at their body fat percentage.

    Body Fat Percentage

    Body fat percentage is exactly what it says on the tin: of your total body weight, how much of it is fat tissue? Thereโ€™s no confusing a muscular athlete for a couch potato, and thereโ€™s no confusing someone with normal-weight obesity for a healthy normal-weight person, so body fat percentage is a better measurement of someoneโ€™s likeliness to develop health problems caused by too much or too little fat tissue.

    Great, right? The problem with body fat percentage is that itโ€™s much harder to measure than BMI. For most of the available methods, you basically have to choose between accuracy and convenience.

    MethodAccuracyCostConvenience
    Predictions based on BMIVery poorFreeVery convenient
    CalipersBetter than BMI predictions, but not great. Better if a professional does it for you, but that's less convenient.CheapReasonably convenient
    DEXA (Dual-Energy X-ray Absorptiometry) scanVery accurateExpensiveTypically inconvenient
    Hydrostatic weighingVery accurateExpensiveTypically inconvenient
    Bioelectrical impedance (this is the method used by most body fat scales)Depends on the type and location of measurement; most home scales arenโ€™t great.ModerateReasonably convenient
    Air-displacement plethysmography (BOD POD)Reasonably accurateExpensiveTypically inconvenient

    What If Precise Numbers Donโ€™t Matter?

    That might be pretty discouraging โ€“ thereโ€™s a more accurate measure of health, but itโ€™s hard to measure. But what if you donโ€™t necessarily need to know your precise body fat percentage? What if itโ€™s enough just to know that body fat is more important than BMI?

    For one thing, if youโ€™re trying to lose fat, you can get a relatively accurate measurement of progress by using the same method under the same circumstances every time. Say you use calipers and they overestimate your body fat percentage by 5 percentage points (e.g. you have 20% and they tell you 25%). You can still use those calipers to track your downward progress, even if the exact number isnโ€™t accurate.

    For another thing, knowing the importance of body fat puts the focus of โ€œhealthโ€ on being fit, not just thin. With so many people obese at a โ€œnormalโ€ BMI, thinness obviously isnโ€™t a measurement of a normal body fat percentage. Calorie restriction for thinness isnโ€™t the answer; the focus shifts to eating well for metabolic health, and to exercise and fitness โ€“ for getting rid of fat around the organs that may not be visible but still causes health problems.

    Measuring by BF% gives you permission to build muscle โ€“ which is healthy! โ€“ even if the scale goes up. Your weight may have increased, but your body fat percentage went down. Way too many people panic when they gain weight from heavy resistance training, even if their body looks fantastic and their clothes are fitting great. If you know that body fat is more important than BMI, this just isnโ€™t an issue: the weight is muscle, everything is fine, no reason to worry.

    One day, weโ€™ll probably have a measurement of body fat percentage thatโ€™s both accurate and convenient โ€“ but until then, just knowing about the importance of body fat is already helpful.

    Summing it Up

    Body Fat Percentage

    BMI is useful for measuring the overall population, but itโ€™s not terribly relevant to individuals. Looking at body fat instead eliminates a lot of the potential for inaccuracy with BMI โ€“ people who are fit with a lot of muscle mass are clearly sorted out from people who are unfit with a high fat mass. And even if you can't accurately measure your own body fat percentage - most of us don't have easy access to a DEXA scanner - just knowing that it's important helps to motivate a very different approach to health, where the emphasis is on fitness and eating well, not just thinness and eating less.

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