Weight problems was categorised as a illness by the American Medical Affiliation (AMA) in 2013, and physicians then started to just accept physique mass index (BMI) as a strategy to measure a affected person’s well being danger — and to persuade insurers to cowl remedies.
Now, 11 years later, the AMA is warning medical doctors that BMI doesn’t inform the entire story.
Throughout its annual assembly in June 2023, AMA delegates authorised a brand new coverage encouraging physicians to make use of BMI solely at the side of different measurements, equivalent to visceral fats, physique adiposity index, relative fats mass, waist circumference, metabolic operate, and genetic elements.
“There are quite a few issues with the way in which BMI has been used to measure physique fats and diagnose weight problems, but some physicians discover it to be a useful measure in sure situations,” famous the group’s quick previous president, Jack Resneck Jr., MD. “It can be crucial for physicians to know the advantages and limitations of utilizing BMI in scientific settings to find out the perfect care for his or her sufferers.”
BMI is usually a helpful metric when assessing population-level tendencies, says Mayo Clinic heart specialist Francisco Lopez-Jimenez, MD, however it could’t distinguish between fats, muscle, and bone. And since it was initially accepted as an correct weight metric primarily based on analysis that largely excluded racial minorities, it tends to ship deceptive knowledge when utilized to BIPOC sufferers.
Black sufferers usually have decrease body-fat percentages and extra muscle mass in comparison with white folks displaying the identical BMI, Lopez-Jimenez tells Scientific American. Folks of Asian descent, alternatively, have a tendency to hold extra physique fats than what their BMI suggests. In each circumstances, physicians could also be making diagnoses with out correct data.
“Counting on BMI to diagnose weight problems,” he argues, “is like diagnosing diabetes on the idea of weight as an alternative of testing somebody’s blood-sugar degree.”
For a extra dependable image, Lopez-Jimenez advises physicians to make use of DEXA scans, which may estimate a affected person’s fats tissue, in addition to to test blood strain and order blood checks to measure ldl cholesterol and triglycerides. “That offers us a greater image in regards to the well being danger of a affected person.”
