American Medical Association leaders have taken a step away from using a single number to determine your health and wellness, telling doctors around the United States that Body Mass Index (BMI) is not worth using alone.
The association’s immediate past president, Dr. Jack Resneck Jr., highlighted just how difficult a decision this can be for primary care providers and the patients they serve.
“There are numerous concerns with the way BMI has been used to measure body fat and diagnose obesity, yet some physicians find it to be a helpful measure in certain scenarios,” Resneck said in a news release Wednesday.
During its annual meeting in Chicago, the body of nearly 200 state and specialty medical societies discussed an AMA Council on Science and Public Health report meant to evaluate the race, gender and age-based differences that the index does not account for. They determined a number of situations in which BMI use alone was inappropriate.
“The use of BMI is problematic when used to diagnose and treat individuals with eating disorders because it does not capture the full range of abnormal eating disorders,” the council’s report said.
Critically, the association said, body mass index does not directly address body fat and its classification system can be misleading.
“Numerous comorbidities, lifestyle issues, gender, ethnicities, medically significant familial-determined mortality effectors, duration of time one spends in certain BMI categories and the expected accumulation of fat with aging are likely to significantly affect interpretation of BMI data, particularly in regard to morbidity and mortality rates,” the council’s report said.
The AMA added that since body shape and composition differ across various groups, doctors need to avoid using BMI as a sole criterion for denying something like appropriate insurance reimbursement.
“It is important for physicians to understand the benefits and limitations of using BMI in clinical settings to determine the best care for their patients.”
The decision comes amid a report that nearly half the world would be overweight or obese by 2035. That report relied on definitions of normal weight rooted in the embattled body mass index.
“This year’s Atlas is a clear warning that by failing to address obesity today, we risk serious repercussions in the future,” said Louise Baur, president of the World Obesity Federation. “It is particularly worrying to see obesity rates rising fastest among children and adolescents.”
For adults, the AMA said measuring BMI and waist circumference could better predict any weight-related risks to patients. For children, however, BMI-for-age remains “the gold standard.”
Policy changes from the association also follow a reported increase in weight loss surgeries among children and teens and a shift toward the use of medicines like Ozempic, which are in a nationwide shortage, as an aid to weight loss.