BMI 30: What To Do?

What does BMI 30 mean?

Body Mass Index (BMI) is calculated by dividing your weight in kilograms by your height in metres squared. A BMI of 30 to 35 falls into the category class I obesity; 35 to 40 is class II; above 40 is class III (morbid obesity).

In concrete terms, a BMI of 30 means: if you are 1.70 metres tall, you weigh around 87 kilograms or more. For a person of 1.80 metres, this comes to approximately 97 kilograms.

Important: BMI is a crude measure. In someone with a lot of muscle mass, a BMI of 30 can be physiologically normal. In sedentary people with a lot of belly fat, it usually underestimates the health risk.

Health risks

A BMI of 30 or higher increases the risk of: type 2 diabetes (3 to 7 times), hypertension (2 to 3 times), cardiovascular disease, certain cancers (bowel, breast, kidney, uterus), sleep apnoea, osteoarthritis in knees and hips, fertility problems and fatty liver disease (MASLD).

The good news: as little as 5 to 10 percent sustained weight loss reduces these risks considerably. Research shows that people who lose 10 percent lower their diabetes risk by 58 percent and significantly improve their blood pressure.

When assessing your personal risk, not only BMI counts but also waist circumference (risk increased at >88 cm for women, >102 cm for men), blood pressure, cholesterol, glucose, age and family history.

First steps: GP and GLI

The first step at a BMI of 30 is a conversation with your GP. You are entitled to blood tests (glucose, HbA1c, lipids, liver, kidney and thyroid function) and a health assessment. A referral may follow on that basis.

The Combined Lifestyle Intervention (GLI) is a two-year programme fully covered by basic health insurance. You work with a lifestyle coach, dietitian and physiotherapist on nutrition, exercise, sleep and behaviour. The programme is proven effective for people who enter it motivated.

Drawbacks of GLI alone: it takes a lot of time, and for around 60 percent of participants weight loss after 2 years is less than 5 percent. For this group, pharmacological support can be a valuable addition.

Medication at BMI 30: what is possible?

Formally, Wegovy is only reimbursed in the Netherlands from BMI 35 with comorbidity. At a BMI of 30 you therefore do not qualify for reimbursement, but you do qualify for off-label use of semaglutide (Ozempic) or tirzepatide (Mounjaro), prescribed by a BIG-registered doctor.

Off-label means you use the medicine for an indication other than the one for which it is primarily registered, but in a medically responsible way. At a BMI of 30 with health risks, this is usually well justified.

With off-label use, costs are at your own expense. At specialised clinics this is usually included in an all-in monthly subscription covering consultations, blood tests and coaching.

Lifestyle: nutrition and exercise

Medication works best in combination with lifestyle changes. Focus on protein-rich eating (at least 1.2 grams per kilo of body weight), vegetables, wholegrain products and healthy fats. Limit processed sugars, fast carbohydrates and ultra-processed food.

Strength training is essential to preserve muscle mass during weight loss. Aim for 2 to 3 strength sessions per week plus 150 minutes of moderate cardio (walking, cycling, swimming).

Sleep and stress are underestimated factors. Less than 7 hours of sleep per night raises hunger hormones (ghrelin) and lowers satiety hormones (leptin). Chronic stress stimulates fat storage around the abdomen via cortisol.

Treatment at Go Leaner

At Go Leaner we always start with a comprehensive intake consultation with a BIG-registered doctor. We assess whether pharmacological treatment is appropriate, which medicine best suits your situation and which dosing strategy is realistic.

Our treatment is all-in: medication, doctor consultations, blood tests, lifestyle coaching and unlimited contact via the app. From 199 euros per month we start with Ozempic, from 249 euros per month with Wegovy or Mounjaro. Cancel monthly without penalties.