The Beginning of the End of BMI?

A doodle sitting in their office typing up the AMA's new policy. A framed AMA logo is on the wall.

This week, we’re discussing something we often encounter in health comm: BMI, or body mass index. As you probably know, BMI is a number calculated using a person’s height and weight. In the most basic terms, doctors (and insurance companies!) use it to put people into 1 of 4 categories: underweight, healthy weight, overweight, and obesity. This is supposed to help assess how much body fat a person has and their relative health.

But, as you also probably know, BMI has long faced criticism from experts in just about every relevant discipline — not-so-favorable characterizations have ranged from just not that useful for individuals to a racist, sexist, misused tool that’s done serious harm. Regardless, for the most part, BMI has stuck around. But a recent announcement from the American Medical Association (AMA) may be about to change that, and we’re here for it.

Last month, the AMA issued a press release detailing its new policy that clarifies how BMI should be used (with “other valid risk measures”) and aims to build that knowledge among health care providers. The release references a report that concluded BMI is “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.” The press release doesn’t mince words:

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 policy noted 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 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.

Well! It certainly sounds like this could have some serious (and overdue) implications for the health care field and health communicators like us. There’s a lot to say about how this might affect the conversation about weight in health care more broadly (be on the lookout for more on that!). But for now, we’d love to hear from you: Does BMI have a place in health care? Are you celebrating its apparent demotion? What broader implications could this update have? How should we contextualize BMI in plain language health materials?

Respond to this email or find us on social (LinkedIn or Twitter) and let us know what you think! And to learn more about this topic, check out the July issue of AMA’s Journal of Ethics — it includes multiple articles that explore BMI’s history, its current use, and related ethical issues.

The bottom line: Hats off to the American Medical Association, which recently released a new policy scrutinizing BMI and clarifying its appropriate use. This could have big implications for health care (and health comm).

Tweet about it: This week, the @CommunicateHlth crew is chatting about @AmerMedicalAssn’s new #BMI policy, which could have big implications for health care (and #HealthComm): #HealthLiteracy


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