Why Weight Recommendations Are the Same for Men and Women

The same BMI recommendations are used for men and women. Although to some this doesn't seem right, the reason is that health risks increase at about the same BMI for both genders.
Ripples in Water

Many people challenge the fact that the same BMI recommendations apply to both adult men and women. Since men tend to 'look better' at a higher BMI than women, it seems intuitive that the healthy weight for a man of the same height as a woman would be higher. But this is not the case. Medical experts have learned that, as BMI increases above 25, so does ill health.1 Moreover, the ill health effects show up at about the same BMI for men and women.

Chan J et al. Diabetes Care 1994;17:961.
Colditz G et al. Ann Intern Med 1995;122:481

Men, Women and Risk for Diabetes
The mortality rate among people with type 2 diabetes is 11 times higher than for those without the disease.2 More women than men have type 2 diabetes because there are more obese women than men.3 As the chart (above) illustrates, however, both genders show a consistent progression in the risk for diabetes as the BMI goes above 25.

What the chart does not clearly show, however, is the increased risk for the 'average' man and woman. In a large analysis done in men, the authors found that today's 'average' man, with a BMI of 28, has almost a 16 fold increase of diabetes risk compared to men with a BMI of 23 or less.4 The same holds true for women, but to a lesser degree. In another study involving a large number of women, the researchers found that the 'average' woman, with a BMI of 24, has a 5 fold higher risk for developing diabetes when compared to females with a BMI of 22 or less.5

Calle et al. N Engl J Med 1999;341:1097.

Men, Women and Cardiovascular Disease
Heart disease accounts for 40% of the deaths in industrialised countries.6 It is the leading cause of death for both men and women. The lack of gender difference as it relates to weight and the risk of death from heart disease is striking. As the chart (above) shows, there is a steady and progressive increase between BMI and mortality; there is virtually no difference between men and women.

As with diabetes, looks can be a bit deceiving. In a very large study looking at healthy men and women who had never smoked, the BMI range that corresponded to the lowest risk of death from heart disease was 23.5 to 24.9 in men and 22.0 to 23.4 in women.7 If, however, you look at the risk for the 'average' man, it jumps to about 1.4. The 'average' woman's risk, on the other hand, is just slightly higher than the level that corresponds to the lowest risk.