Amid the buzz around weight loss drugs and rising rates of obesity worldwide, many health care professionals are questioning one of the key measures that has long been used to define obesity.
On June 14, 2023, the American Medical Association adopted a new policy, calling on doctors to deemphasize the role of body mass index, or BMI, in clinical practice.
The statement by the AMA, the nation’s largest association representing physicians, signals a significant shift in how clinicians regard BMI as a measure of general health. With over 40% of Americans having obesity as defined by BMI, a movement away from BMI could have broad implications for patient care.
As a board-certified obesity medicine physician with a research interest in patient-centered obesity care, I have written before about my concerns over use of BMI as a measure of health. The AMA’s policy statement creates an important opportunity to review the current use of BMI in health care settings and to consider what the future holds for the assessment of the health risks of elevated body weight.
BMI Basics
Body mass index is a measurement taken by dividing body weight in kilograms by height in meters squared. The metric was developed to estimate a normal body weight depending on an individual’s height, given that taller people tend to weigh more.
It rose to prominence for clinicians in the 1990s following the World Health Organization’s adoption of the metric as the official screening index for obesity.
Research has consistently shown that BMI at a population level correlates strongly with body fat percentage and risk for serious health conditions. The index is easy to measure and inexpensive to calculate, allowing its wide implementation in health care settings.
Major Limitations
Because of that ample body of evidence from previous decades, one of the long-standing assumptions in the use of BMI as a measure of general health is that it accurately predicts an individual’s body fat percentage and, therefore, the potential health risks of elevated weight.
However, while BMI may have strong correlations with the amount of body weight composed of body fat in studies
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