BMI alone isn’t enough to assess health, says American Medical Association

The American Medical Association voted Tuesday to adopt a new policy encouraging doctors not to rely solely on the long-used but potential BMI. misleading An index for assessing weight and health.policy officially acknowledged It points to BMI’s “historic harm” and says the metric has been used “for desegregation.”

“This is a pretty big change,” said Dr. Cynthia Romero, director of the M. Foscue Brock Institute for Community and Global Health at Eastern Virginia Medical School, who helped develop the new policy. “Now we have to be more careful and more holistic when it comes to patient care.”

The policy could be a first step away from the medical model that encourages people above a certain BMI to lose weight without considering the potential cost of weight-loss measures, says an assistant professor of medicine. Dr. Scott Hagan said. The University of Washington studies obesity and was not involved in this decision. “It’s a really big deal,” he said. Although the AMA has had an impact on the medical community, the new recommendations are merely suggestions for physicians, not hard-and-fast rules that physicians must follow.

Going forward, the association, one of the country’s largest medical associations, will advise doctors not to use BMI alone to assess whether a patient is of a healthy weight. The AMA suggested that doctors also consider factors such as someone’s illness. Visceral fat (fat stored around the abdominal cavity and organs), body fat index (calculated using hip circumference and height), percentage of fat, bone and muscle in the body, genetic and metabolic factors such as abnormal blood sugar levels and thyroid tests.

BMI is simple calculation with a complicated past. It is generated by taking your weight in kilograms and dividing it by your height in meters squared. Critics have long argued that the measure is an inaccurate measure of health because a person with more muscle and less fat may have the same BMI as an obese person.

“BMI is a very poor measure of general health,” says Dr. Hagan. “People with high BMI are likely to be perfectly healthy.”

Leslie Heinberg, director of the Center for Enterprise Weight Management at the Cleveland Clinic, said where you carry your weight is important. Belly fat is associated with higher rates of type 2 diabetes and cardiovascular disease than fat around the waist, but the metric doesn’t capture the nuances, he said.

“Although there are many concerns about how BMI has been used to measure body fat and diagnose obesity, some physicians believe that BMI is a useful measure in certain circumstances.” said Dr. Jack Lesneck Jr., who has resigned as AMA president. Doctors added in a statement this month that they need to understand both the benefits and limitations of the indicator.

At the population level, BMI is “probably the best we can do” in assessing large groups of people, says Ilya Gutin, program officer at the National Academy of Sciences, Engineering, and Medicine and a research institute at the University of Texas at Austin. That’s it,’ he said. He said he is also studying this indicator and applauds the new policy. It’s also cheap and efficient.

But A. Janet Tomiyama, a professor of psychology at the University of California, Los Angeles who has studied BMI, said BMI “is not a magic or powerful number that determines whether you are healthy or sick.” He was “shocked” about the new policy. “I’ve been in this Naked Emperor situation for a long time. I just don’t understand why really smart doctors keep relying on something so obviously flawed.”

The new policy also emphasizes that BMI is primarily data-driven. pulled from Targeting the previous generation of non-Hispanic whites makes it difficult to apply the measure to the broader population.

Despite the backlash against this metric, it remains widely entrenched.

“A lot of our standards and guidelines are built around that,” Dr. Gutin said. “Once that happens, it becomes very difficult to change the inertia.”