Due to significant limitations associated with the widespread use of body mass index (BMI) in clinical settings, the American Medical Association (AMA) now suggests that it be used in conjunction with other valid measures of risk such as, but not limited to, measurements of visceral fat, body adiposity (the fact or condition of having much or too much fatty tissue in the body) index, body composition, relative fat mass, waist circumference, and genetic/metabolic factors.

Delegates at the Annual Meeting of the AMA House of Delegates adopted this new policy aimed at clarifying how BMI can be used as a measure in medicine. The new policy was part of the AMA Council on Science and Public Health report which evaluated the problematic history with BMI and explored alternatives.

The report also outlined the harms and benefits of using BMI and pointed to BMI as 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. Given the report’s findings, the new policy supports AMA in educating physicians on the issues with BMI and alternative measures for diagnosing obesity.

Under the newly adopted policy, the AMA also 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 (the fact or condition of having much or too much fatty tissue in the body) and that BMI should not be used as a sole criterion to deny appropriate insurance reimbursement.

“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.”