BMI is the LEAST important number in your "health screening"; resting pulse, BP, cholesterol numbers, etc., are far more telling about your health. And appearance is nothing but vanity.
I'm 'a bit chunky' -- by BMI standards, about 30 pounds overweight -- but my health numbers are good, I'm strong, I have better endurance than half the 20-somethings out there -- and I couldn't really care any less about how I "look" to other people, or even the mirror.
As far as the genetics, go, it's simple -- genetics know better than you do how you're supposed to be. Health issues creep in with the lifestyle -- predisposed to hypertension? Eat low-salt. History of diabetes? Stay conservative with sugars. And EVERYONE -- exercise, exercise, exercise! It's not a magic bullet -- nothing is -- but it will help, and the earlier you start, the better. (My daughter got 'scared straight' about excessive sugar consumption by her mother, who related the family history of diabetes, and she's 12)
All of this business about BMI's, diets, and all that is as much targeted to the "Hollywood ideal" as it is overall health. We as a society are so programmed to think the 'beautiful people' in films and TV are the standard, that voices like mine get routinely drowned out by the chants involved in hero worship. Screw that -- when a movie star is paying my mortgage, then they will matter.