AMA: BMI Metric Has Caused 'Historical Harm'

American Medical Association says body mass index as a tool is not only inaccurate, but racist
By Jenn Gidman,  Newser Staff
Posted Jun 16, 2023 9:59 AM CDT
Updated Jun 18, 2023 12:15 PM CDT
American Medical Association: This Health Metric Is Racist
Stock photo.   (Getty Images/SOMNATH MAHATA)

There's long been pushback on using body mass index, or BMI, as a health gauge. Critics say the metric—which claims to measure body fat simply by carrying out a calculation involving one's height and weight—might assign the same BMI to a person who has a lot of muscle as to someone who's obese. It also doesn't account for how a person's fat is distributed (ie, abdominal fat is generally worse healthwise than hip fat, per the New York Times). Now, there's a new official admission about it, courtesy of the American Medical Association. As Quartz succinctly puts it, BMI "is also racist," according to the AMA. That's why on Tuesday, the group voted yes on a new policy that alters how it thinks BMI should be utilized as an arbiter of a person's overall health.

In a release, the AMA cites the "historical harm" that's taken place at the hands of BMI measurements, which the group says have been used for "racist exclusion." Quartz delves into the metric's origins, noting its establishment in the 1830s by a Belgian mathematician who used data only from white European men. The metric was also originally intended to be used at the population level, not for individuals. Then, in 1972, a study by physiologist Ancel Keys jump-started the widespread use of BMI as a tool in doctors' offices. The gauge has since "contributed to the misdiagnosis of some people, especially of color" and "used to pathologize bodies that don't adhere to a white standard," becoming "a tool of racism in society and health care," notes Quartz.

An individual's BMI isn't just a vanity number. Negative reactions against it can cause real-world repercussions, including causing a person to be denied for life insurance or health insurance coverage for certain treatments, Quartz notes. Having a too-high BMI could also lead doctors to advise patients to lose weight, even if they don't need to. "The BMI is just a very poor measure of general health," the University of Washington's Dr. Scott Hagan tells the Times. "Someone with an elevated BMI may be perfectly healthy." The AMA isn't suggesting doctors completely nix BMI from a patient's health assessment: The group notes in its release that BMI be used in tandem "with other valid measures of risk such as, but not limited to, measurements of visceral fat, body adiposity index, body composition, relative fat mass, waist circumference, and genetic/metabolic factors." (More BMI stories.)

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