The American Medical Association (AMA) is discouraging doctors from using only Body Mass Index (BMI) to measure whether a person is a healthy body weight because the system is “racist.”
BMI has been widely used because it is easily measured, is inexpensive, and has specific cutoff points for the overweight and obese classifications, the AMA said in a post on its website Wednesday.
However, BMI has been used for “racist exclusion” and has caused “historical harm,” the medical organization said.
The AMA’s House of Delegates adopted a new policy this month recognizing the issues with using BMI.
“Under the newly adopted policy, 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,” the AMA said in a press release.
The new policy comes after the AMA Council on Science and Public Health presented a report addressing the BMI issues at the 2023 AMA Annual Meeting, which was held June 9 to 14 in Chicago.
There are other issues with the BMI system, too, the AMA said.
BMI is an “imperfect measure” because it does not directly assess body fat and is “misleading about the effects of body fat mass on mortality rates,” the AMA’s post said.
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The BMI system also does not account for differences across the sexes, genders, and age-span, the new policy says.
“Further, 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 report said.
BMI should be used along with other measures like body composition, waist circumference, and genetic and metabolic factors, the new AMA policy says.
“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,” said AMA Immediate Past President Jack Resneck, Jr. M.D. “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 AMA said it will support efforts to educate physicians on the issues with BMI and alternative measures for diagnosing obesity.
The AMA is the largest organization of doctors in the nation with more than 271,000 members.
In recent years, the body positivity and fat positivity movements have picked up steam in the U.S., arguing that obese people can be healthy.
Fat activists have rebelled against “diet culture” and made specific demands like free extra seats on airplanes to accommodate their size.
In December, Time Magazine published an article titled, “The White Supremacist Origins of Exercise,” while Cosmopolitan’s February 2021 issue featured plus-sized models with the headline, “This is Healthy!”
Meanwhile, doctors have pointed out that weight gain doesn’t always correlate to fat gain. For example, some people who exercise will end up gaining muscle weight, which will add to their overall weight.