The AMA is one step closer to saying BMI is bogus, calling out its limitations and racial bias

• The largest medical association in the country is slowly changing its stance on the BMI.
• The American Medical Association announced that using BMI to measure health risk has significant limitations.

The American Medical Association (AMA), the largest medical association in the US, is one step closer to saying what many health advocates have known for years: The body mass index (BMI) chart is a bogus measure of health.

After its annual meeting in Chicago this week, the organization of more than 270,000 doctors announced that it had adopted a new policy to clarify how the BMI should be used as a measure in medicine. The announcement noted that a report from an organization subcommittee published earlier this year found that while using the BMI as a measure of health has some advantages — namely that it's quick, cheap, and easy to use — it has many more disadvantages.

Due to the BMI's "significant limitations," the policy said, going forward it should only be used in conjunction with other health measurements such as measurements of visceral fat, body composition, waist circumference, genetic factors, and more.

"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," Jack Resneck, Jr., the AMA immediate past president, said in the announcement. "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 association's new president, Jesse M. Ehrenfeld, was sworn in on June 13.

The limitations of BMI

Even though the BMI has been used extensively in doctor's offices for years, it may not be a good measurement of your level of health.

"It doesn't tell you anything about the health of a person," Dr Fatima Cody Stanford, an obesity medicine physician and associate professor of medicine and pediatrics at Harvard Medical School, previously told Insider reporter Marianne Guenot.

The BMI was created in the 1800s by Albert Quetelet, who was a statistician, not a doctor. He created the BMI chart by calculating the weight (in kilograms) divided by the squared height (in meters) of white French and Belgian men, which unsurprisingly means that the chart is inaccurate for most of the world's population.

"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 association wrote in its announcement.

According to the AMA 2023 subcommittee report the BMI as a measurement tool has several other limitations, which include:

• It does not differentiate between lean body mass and body fat mass (meaning people with lots of muscle and a lot body fat percentage can still have a high BMI)
• It does not account for body fat location (body fat in the stomach region has been shown to lead to heart disease and diabetes, compared to body fat located in the hips and thighs)
• It does not account for hormonal changes, which puts many postmenopausal woman at the higher end of the BMI scale
• Predicting health outcomes based on BMI only likely isn't as accurate as looking at genetics, medical history, and environmental factors
• People with eating disorders can still have high BMIs, which can hinder them from getting access to treatment

The AMA suggests that doctors use other tests to diagnose obesity and measure health risks instead, including measuring waist-to-hip ratio, using skinfold calipers, or, if the technology is available, underwater weighing.