Health
Is it time to trade in your BMI for roundness?
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General practitioners need to move away from using BMI as a diagnostic tool, says one expert in the field. So how do we calculate a patient's weight risk?
Medical standards and practices have come a long way since the 1800s, but apparently not when it comes to calculating a patient's weight risk.
Body mass index (BMI) was created by statisticians in 1832; About the “average person”but it is still widely used today to assess someone's weight status (underweight, normal, overweight, or obese).
This measurement is questioned Although it has been measured many times over the years, no other estimate is more commonly used in medical practice to assess a patient's weight.
But is it time for GPs to put BMI aside?
Recently, new measurement systems have been attracting attention. Promising new anthropometric scales – Body Roundness Index (BRI).
BRI works to determine a person's “roundness” by relating waist circumference to height, and to establish visceral adipose tissue volume.
At the beginning of this year, Study of 33,000 US adults Additionally, the association between BRI and all-cause mortality revealed a significantly increased risk of death in both the lowest and highest BRI groups.
But it's not as simple as trading BMI wholesale for the BRI, says RACGP Special Interest Obesity Management Chair, GP and nutritionist Dr Terry Lynn South.
Dr. South said: News GP Although GPs have historically relied too heavily on BMI, BRI has its own limitations.
“It's hard enough to measure your BMI, but I think it's even harder to measure your waist,” she said.
“There is disagreement about the definition of where to properly measure a person's waist.”
However, Dr. South also does not endorse BMI as a comprehensive approach.
“While we know that BMI is correlated with metabolic health, the actual causal relationship is more complex,” she says.
“You can have two different bodies with high BMIs, but depending on your body composition, your metabolic health risks will be very different.”
Instead, she says GPs should use these types of measurements as part of a holistic approach.
“We need to continue to use BMI, but we need to move it into a screening tool and add other measurements such as waist circumference, blood pressure, pathology, and blood tests, meaning a single measurement “It's not just about using , it's about labeling people in terms of obesity,” she said.
Dr. South advocates for an overhaul of the categorical system that categorizes people into silos of underweight or overweight and instead intervenes based on risk.
“We need to start moving away from putting people into such categories,” she says.
“I think we have a long way to go because we have been fixated on using healthy weight ranges and BMI for management purposes for a long time.
“It's going to take some excitement to turn that into a more individualized and holistic assessment, but I think we'll get there.”
Dr. South believes that the process behind weight assessment may proceed as follows: cardiovascular risk.
“Over 15 years ago, we talked a lot with our patients about total cholesterol, and now we make decisions based on total cholesterol,” she said.
“We're looking at a much broader range now, there are a lot more parameters, and we expect that obesity management will eventually get to that point.”
But Dr. South says there's a lot of work to do before we get there.
“The field is undergoing major changes, as is our understanding that obesity is a chronic and complex condition,” she says.
“Things have changed a lot in my professional life alone. I think it will require a lot of education and upskilling of all health care workers, as well as the general public.”
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BMI body mass index metabolic medicine obesity too fat overweight and obesity preventive health stigma
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