The American Medical Association (AMA) has highlighted the drawbacks of relying solely on the body mass index (BMI) metric as an indicator of health, calling it an “imperfect measure” that has caused “historical harm.”
In a recent blog post on its website, the AMA acknowledged that BMI has been widely used due to its simplicity, affordability, and clear thresholds for classifying individuals as overweight or obese. However, the metric does not directly measure body fat and the current classification system fails to accurately reflect the impact of body fat mass on mortality rates.
According to a report presented by the AMA Council on Science and Public Health at its annual meeting, several factors, including comorbidities, lifestyle choices, gender, ethnicity, family history, duration of time spent in different BMI categories, and the expected accumulation of body fat with age, significantly influence the interpretation of BMI data.
The report also emphasizes that BMI is not well-suited for diagnosing and treating individuals with eating disorders, as it does not encompass the entire spectrum of these disorders.
Former AMA president Jack Resneck Jr. explained, “While there are concerns with using BMI as a measure of body fat and obesity, some physicians find it helpful in certain scenarios. It is important for physicians to understand the strengths and limitations of using BMI in clinical settings to provide optimal care for their patients.”
Based on the report, the AMA House of Delegates adopted a policy acknowledging the problems associated with BMI, including its historical harm, potential for “racist exclusion,” reliance on previous generations of non-Hispanic white individuals, and disregard for gender and ethnicity considerations.
The policy also recognizes the significant limitations of using BMI in clinical settings and recommends its use in conjunction with other valid measures, such as body composition, waist circumference, and genetic and metabolic factors.
The AMA intends to support further research on extended BMI percentiles, their relationship to other measures, risk factors, and health outcomes, and efforts to educate medical professionals on the limitations of BMI and alternative methods for diagnosing obesity.
Lauren Smolar, a spokesperson for the National Eating Disorders Association, expressed concern about the stigma surrounding weight caused by BMI and its potential to deter individuals with eating disorders from seeking treatment.
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