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News
BMI alone isn't enough to gauge mortality risk in older adults. A 14-year study of Medicare beneficiaries found that high waist circumference was linked to a 24% greater risk of death — even in those with a normal BMI. Clinicians may need to routinely measure waist size alongside BMI to better identify at-risk older patients.
A large 14-year study of nearly 7,000 Medicare beneficiaries (aged 65+) found that waist circumference (WC) is a stronger and more nuanced predictor of mortality than BMI alone. Interestingly, being overweight by BMI was actually associated with lower mortality risk — 46% lower in men and 27% lower in women — a well-known phenomenon called the "obesity paradox" in older adults.
But here's the catch: regardless of BMI category, a high waist circumference raised the risk of death by 24% in both men and women. Even older adults with a perfectly "normal" BMI faced a 23–33% higher mortality risk if their waist size was elevated — meaning BMI alone can miss a critical danger signal.
Key Takeaways:
Why it matters: For clinicians seeing older patients, this study makes a strong case for adding waist circumference to routine assessments. BMI alone can mask dangerous central adiposity — especially in aging bodies where muscle loss can make weight appear "normal" even when fat distribution signals elevated risk.
