AMA: Using BMI alone is an incomplete clinical measure

Body mass index (BMI) is easy and inexpensive to measure. There are also standardized cut-off points for overweight and obesity, which are strongly correlated with body fat levels measured by the most accurate methods. However, BMI is an imperfect measurement because it does not directly measure body fat.

In addition to this, according to the AMA Council on Science and Public Health report presented at the 2023 AMA Annual Meeting in Chicago, the current BMI classification system does not support the effect of body fat mass on mortality. It is easy to cause misunderstanding.

“Many comorbidities, lifestyle issues, gender, ethnicity, medically significant family-determined mortality-influencing factors, time spent in specific BMI categories, and expected fat accumulation with aging are In particular, it is likely to have a significant impact on the interpretation of BMI data: morbidity and mortality,” the council’s report said. “Additionally, BMI does not capture the full spectrum of unusual eating disorders, making it problematic when used to diagnose and treat people with eating disorders.”

For adults, measuring BMI and waist circumference may be a better predictor of weight-related risk. However, since there is no adequate reference data on waist circumference for children, her BMI by age has become the most important standard.

“Although there are many concerns about how BMI is used to measure body fat and diagnose obesity, some physicians believe that BMI is a useful measure in certain scenarios.” AMA former president Jack Lesneck Jr., M.D., said. “For a physician to determine the best care for a patient, it is important that he understands the benefits and limitations of using BMI in a clinical setting.”

The House of Representatives has adopted a new policy that recognizes the problems of using BMI as a measure for the following reasons.

• About the historical harm of BMI.
• On using BMI for desegregation.
• BMI cutoffs are primarily based on data collected from previous-generation non-Hispanic Caucasian populations and do not take into account a person’s gender or ethnicity.

Additionally, the policy states that there are significant limitations to the widespread use of BMI in clinical practice, and that the use of BMI should be used in conjunction with other validated risk measures, such as the following measures​ recommended.

• Visceral fat.
• body fat index.
• body composition.
• relative fat content.
• girth.
• genetic or metabolic factors;

The newly adopted AMA Policy also states:

• BMI is significantly correlated with fat mass in the general population, but loses predictability when applied to the individual level.
• When applying BMI as a measure of obesity, it is imperative to consider relative body type and composition heterogeneity across race, ethnicity, sex, sex and age groups.
• Use of BMI should not be used as the sole criterion for denying proper reimbursement.

AMA also supports:

• Further studies on the application of extended BMI percentiles and Z-scores and their association with other anthropometric measures, risk factors and health outcomes.
• Efforts to educate physicians about BMI issues and alternatives for diagnosing obesity.

In addition, participants modified existing policies regarding the clinical utility of measurements of BMI, body composition, body composition, and waist circumference, stating, supported greater emphasis on risk differences within and between demographic groups’ waist circumference, and the importance of monitoring these in all individuals. ”

Participants also asked the AMA to amend existing policies on eating disorders to:

• Calls upon all school-based physicians, counselors, coaches, trainers, teachers, and nurses to recognize abnormal eating, dieting, and weight-restricting behaviors in children and adolescents and provide evidence-based education to adolescents and their families. Encourage training to provide appropriate education and appropriate referrals. and culture-based intervention counseling.
• Consult with culturally-appropriate educational and counseling resources about abnormal eating, dieting, and weight-restrictive behaviors.

read about others 2023 AMA ANNUAL MEETING HIGHLIGHTS.