A movement to shift away from BMI as a measure of individual health risk alone is gaining steam. Here's what to know.
Roughly 200 years ago, a Belgian mathematician and statistician named Adolphe Quetelet, seeking to characterize “normal man,” observed that adults’ body weight in kilograms is roughly proportional to the square of their height in meters – a measurement that came to be referred to as the Quetelet index.
“It is noted in every medical record,” said Dr. Jamy Ard, a professor of epidemiology and prevention at the Wake Forest University School of Medicine. “It is part of the consideration for life insurance; your employer may use BMI to offer certain wellness programs to you.” “BMI is based primarily on data collected from previous generations of non-Hispanic white populations,” the AMA wrote. And while it’s “significantly correlated with the amount of fat mass in the general population,” the association said, it “loses predictability when applied on the individual level.”“This is almost like somebody announced that we’ve just figured out that people are going to be using cell phones,” said Dr.
The AMA’s new policy acknowledges those limitations, noting that BMI doesn’t differentiate between lean and fat body mass, and points out that it doesn’t account for differences between racial and ethnic groups, sexes and people at different ages. Put another way, he said, having an “apple-shaped” body “is much more of a risk factor than pear-shaped.”
“More important than BMI, in my opinion, is whether any individual patient has the metabolic syndrome,” said Dr. Willa Hsueh, a professor of medicine and director of the Diabetes and Metabolism Research Center at The Ohio State University’s Wexner Medical Center. She cited elevated triglycerides, low levels of so-called good cholesterol, diabetes or prediabetes, high blood pressure or excess liver fat.
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