FILLER

n a press release from last week, the AMA announced its decision to adopt a new policy to clarify the role of BMI — a simple metric comparing height and weight for the purpose of inferring one’s total body fat — as a measure in medicine. The AMA Council on Science and Public Health report, where the new policy is detailed, evaluates the “problematic history” with BMI — which has been widely used since the early 1970s — as it explores “alternatives.”

According to the announcement, the report also outlines the “harms and benefits of using BMI,” which it deems an “imperfect way to measure body fat in multiple groups given that it does not account for differences across race/ethnic groups, sexes, genders, and age-span.”

In light of the findings, the new policy supports the AMA in “educating physicians on the issues with BMI and alternative measures for diagnosing obesity,” it states, adding that the AMA “recognizes issues with using BMI as a measurement due to its historical harm, its use for racist exclusion, and because BMI is based primarily on data collected from previous generations of non-Hispanic white populations.”

Claiming that BMI is “significantly correlated with the amount of fat mass in the general population but loses predictability when applied on the individual level,” the AMA suggests it be “used in conjunction with other valid measures of risk such as, but not limited to, measurements of visceral fat, body adiposity index, body composition, relative fat mass, waist circumference and genetic/metabolic factors.”

The report continues:

“The AMA also recognizes that relative body shape and composition differences across race/ethnic groups, sexes, genders, and age-span is essential to consider when applying BMI as a measure of adiposity and that BMI should not be used as a sole criterion to deny appropriate insurance reimbursement.”

According to AMA Immediate Past President Jack Resneck Jr. M.D., the way BMI “has been used to measure body fat and diagnose obesity” is subject to various concerns, noting 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.”

Last month, AMA members highlighted the “racist origins” of the BMI, as well as the “flawed science, misperceptions, and stigma that people with obesity encounter.”

In April, a Washington Post essay called to “cancel diet culture” and help children “resist” conforming to “anti-fat expectations.”

Last year, a SELF magazine column claimed “fatphobia” restricts accessibility of fitness endeavors for obese people, while BMI has a “racist history.” 

The essay also linked popular “anti-fatness” to racial prejudice, arguing that “anti-fat bias has been a part of white America for centuries.”

In 2021, Cosmopolitan magazine promoted plus-size women as “healthy.”✪

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