- The American Medical Association, the largest medical association in the country, is revising its stance on the Body Mass Index (BMI).
- Recognizing significant limitations, the association acknowledges the BMI’s racial bias and advises doctors to utilize additional tests.
The American Medical Association (AMA), the largest medical association in the US, is taking a step towards acknowledging a long-held belief among health advocates that the Body Mass Index (BMI) is an inadequate measure of health.
Following its recent annual meeting in Chicago, the AMA announced the adoption of a new policy clarifying the usage of BMI in medicine. According to a report by an organization subcommittee, the BMI has significant limitations despite its convenience and cost-effectiveness.
The policy emphasizes that the BMI should only be used in conjunction with other health measurements, such as visceral fat, body composition, waist circumference, and genetic factors.
“While some physicians find BMI helpful in certain scenarios, there are numerous concerns with its usage as a measure of body fat and obesity diagnosis,” stated Jack Resneck, Jr., immediate past president of the AMA.
Jesse M. Ehrenfeld, the newly inaugurated president of the association, took office on June 13.
The drawbacks of BMI
Despite its widespread use in doctor’s offices, the BMI may not provide an accurate assessment of one’s health status.
“It fails to provide any meaningful information about a person’s health,” explained Dr. Fatima Cody Stanford, an obesity medicine physician and associate professor at Harvard Medical School.
The BMI was originally developed in the 1800s by Albert Quetelet, a statistician rather than a medical professional. The calculation is based on the weight-to-height ratio of white French and Belgian men, making it unreliable for diverse populations.
“Under the newly adopted policy, the AMA recognizes the historical harm, racist exclusion, and limited scope of BMI, which primarily draws from data of non-Hispanic white populations,” stated the association.
The AMA’s 2023 subcommittee report lists several other limitations of BMI:
- It does not distinguish between lean body mass and body fat mass, which means individuals with high muscle mass and significant body fat may register a high BMI.
- It does not consider body fat distribution, despite evidence linking abdominal fat to increased risks of heart disease and diabetes compared to fat in the hips and thighs.
- It does not account for hormonal changes, potentially placing postmenopausal women at higher BMI levels.
- Dependence on BMI alone is less accurate than considering genetics, medical history, and environmental factors when predicting health outcomes.
- Individuals with eating disorders may have high BMIs, obstructing their access to appropriate treatment.
The AMA suggests that doctors employ alternative tests to diagnose obesity and assess health risks, such as waist-to-hip ratio, skinfold calipers, or underwater weighing when available.
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