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Estimating Ideal Body Weight – A New Formula

Article  in  Obesity Surgery · September 2005

DOI: 10.1381/0960892054621350 · Source: PubMed

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Obesity Surgery, 15, 1082-1083

Brief Communication

Estimating Ideal Body Weight – A New Formula

Harry J. M. Lemmens, MD, PhD; Jay B. Brodsky, MD; Donald P. Bernstein, MD

Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA

A simple formula for estimating ideal body weight
(IBW) in kilograms for both men and women is pre-
sented. The equation IBW = 22 x H2, where H is equal
to patient height in meters, yields weight values mid-
way within the range of weights obtained using pub-
lished IBW formulae.
Key words: Ideal body weight, obesity, drug dosage
Many medications are administered on the basis of
ideal body weight (IBW). This is especially impor-
Delivered
tant in the morbidly obese by Ingenta
patient to: Stanford
because certain University
classes of drugs with poor lipophilicity and narrow 127.0.0.1
therapeutic indexes, when administered on:onThu,
the 11 Aug 2005
basis
of total body weight (TBW), can lead to over-
dosage and drug toxicity.1 For patients smaller than
IBW, simply scaling the dose of drug to TBW is
appropriate, because IBW and TBW approximate
each other. However, for morbidly obese patients
who are significantly larger than IBW, drug dosages
should be scaled to IBW, or IBW plus some fraction
of the difference between TBW and IBW.2 How can
IBW be determined?
The concept of IBW was initially proposed by the
Metropolitan Insurance Company to describe a
range of weights associated with longevity for men
and women of different heights.3 Although IBW
tables are available, few clinicians use them and
most rely on one of many complicated formulae to
estimate IBW.4-8 There is no absolute correct IBW
for any individual, and each IBW equation will give
a weight that differs for the same patient. IBW also
varies for different populations, and within the same
Reprint requests to: Jay Brodsky, MD, Department of Anesthesia,
H3580, Stanford University Medical Center, Stanford, CA, 94305,
USA. Fax: 650-725-8544; e-mail: Jbrodsky@stanford.edu
population at different times. For example, with
each new American generation, height-weight
tables have demonstrated a trend for adults to weigh
more than their predecessors while experiencing
similar or even greater longevity.3
We propose a simple approach to estimate IBW
based on the body mass index (BMI). BMI is calcu-
lated by dividing the patient's weight in kilograms
(kg) by the square of their height (H) in meters (m)
(BMI = kg / H2). A BMI between 20-25 is consid-
ered “normal” weight range. An equation, BMI =
IBW / H2 Libraries
or IBW = (cid
BMI5000191)
x H2 can be constructed to
reflect this. A similar concept was recently used to
17:44:28
estimate “normal weight” for fluid administration.9
Using a range of BMI values, we found that for
both men and women, IBW = 22 x H2 yields weights
that fall midway within and “best fits” the range of
values obtained with accepted IBW formulae (Figure
1). We propose this formula as an extremely simple,
rapid, and reproducible means of estimating IBW.
References
1. Cheymol G. Effects of obesity on pharmacokinetics
implications for drug therapy. Clin Pharmacokinet
2000; 39: 215-31.
2. Bouillon T, Shafer SL. Does size matter? (Editorial).
Anesthesiology 1998; 89: 557-60.
3. Pai MP, Paloucek FP. The origin of the ‘ideal’ body
weight equations. Ann Pharmacother 2000; 34: 1066-9.
4. Broca PP. Memoires d'anthropologie. Paris 1871 / 1877.
5. Devine BJ. Gentamicin therapy. Drug Intell Clin
Pharm 1974; 8: 650-5.
6. Robinson JD, Lupkiewicz SM, Palenik L et al.

1082 Obesity Surgery, 15, 2005 © FD-Communications Inc.

 Estimating Ideal Body Weight – A New Formula

120 A Males 100 B Females

IBW (kg) Formulae: IBW (kg) Formulae:

90 53.1 kg (60 inch) + 1.36 kg/inch (ref. 7)
56.2 kg (60 inch) + 1.41 kg/inch (ref. 7)
100
45.5 kg (60 inch) + 2.3 kg/inch (ref. 5)
Ideal Body Weight (kg)

Ideal Body Weight (kg)

50 kg (60 inch) + 2.3 kg/inch (ref. 5)
52 kg (60 inch) + 1.9 kg/inch (ref. 6) 49 kg (60 inch) + 1.7 kg/inch (ref. 6)
80
height (cm) - 100 (ref. 4) height (cm) - 105 (ref. 4)

(1 inch = 2.54 cm) (1 inch = 2.54 cm)

80 70

60
60

A = 23 x Height (m)2 50 A = 23 x Height (m)2

B = 22 x Height (m)2 B = 22 x Height (m)2
A = 21 x Height (m)2 A = 21 x Height (m)2

Height (cm) Height (cm)

Figure 1. Estimated values for ideal body weight (IBW) for both males (A) and females (B) are shown using a variety of
published formulae. The equation IBW = 22 x H2 yields the best fit for both men and women.

Determination of ideal body weight for drug dosage ing weight loss (Editorial). Obes Surg 2003; 13: 159-60.
calculations. Am J Hosp Pharm 1983; 40: 1016-9. 9. Kabon B, Nagele A, Reddy D et al. Obesity decreases
7. Miller DR, Carlson JD, Loyd BJ et al. Determining perioperative tissue oxygenation. Anesthesiology
ideal body weight. (Letter). Am J Hosp Pharm 1983; 2004; 100: 274-80.
40: 1622.
Delivered
8. Deitel M, Greenstein by Ingenta to:for
RJ. Recommendations Stanford
report- University
(ReceivedLibraries
April 12, (cid
2005;5000191)
accepted May 20, 2005)
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on: Thu, 11 Aug 2005 17:44:28

Obesity Surgery, 15, 2005 1083

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