Bye-bye BMI?

The medical field’s heavy reliance on Body Mass Index (BMI) is on track to get an adjustment in its singular use to diagnose health, particularly obesity. BMI has been common for decades and is used by the vast majority of medical providers, including Oregon Medical Group.

“BMI has been troubling to many of us in the field, and across Oregon Medical Group for many years. It’s encouraging to see attention put to removing it as a stand-alone measure,” says Dr. Stacy Chance, Oregon Medical Group’s Chief Medical Officer.

Most patients are familiar with this measurement, which uses a combination of height, weight and age to screen for obesity, which typically correlates to health risks. BMI uses a very broad brush to paint a health assessment. It can even be used to determine eligibility for some medical treatments and life insurance. 

In June, the American Medical Association formally adopted a policy that suggests BMI be used with other measures of health risk and that providers learn more its limitations. The BMI has some use when used in combination with other assessments, but by itself it is an imperfect way to measure body fat in multiple groups. 

Of greatest concern is that BMI does not consider differences between racial and ethnic groups, sexes and people at different ages. The measure is based primarily on data collected from previous generations of non-Hispanic white populations. 

Because BMI does not accurately measure actual body fat, it systematically drops more African-American patients in the category of overweight or obese. At the same time, it places fewer Asian-Indian and Asian men and women in the overweight or obese category. It categorizes fewer Hispanic women as overweight or obese. 

“At Oregon Medical Group we already use BMI only as one part of our conversations with patients,” says Chance. “We’re pleased to see national attention on the topic, and we hope stand-alone use becomes a thing of the past. BMI will continue to have a place for us as one piece of information meant to be used in combination with many other measurements and factors.  This might help ease patient concerns about what is a generalized number that does not always reflect factors such as overall health, race or ethnicity.”