SAN FRANCISCO (KCBS RADIO) – For decades, the Body Mass Index, or BMI, has been used in medicine to measure body fat. However, the approach to using this metric is changing.
Last month, the American Medical Association adopted a new policy acknowledging the BMI’s limitations as a health indicator. This week, Alice Wertz of KCBS Radio’s “As Prescribed” spoke with Dr. Diana Thiara, a primary care physician and medical director at the UCSF Weight Management Program, to learn more.
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“The AMA has put out this position statement saying that the BMI may be useful based on population level data. But when we look at individuals one on one, it may not be the best metric to predict cardiometabolic disease,” Thiara – who is also a Diplomate of the American Board of Obesity Medicine – explained. “And the reason why is that it’s quite limited when it comes to race and sex.”
BMI is generally calculated as weight in kilograms divided by the square of height in meters, per the U.S. Centers for Disease Control and Prevention. According to the AMA, BMI measurements have historically been used to cause harm such as racist exclusion. It also said that data used to inform BMI calculations has typically been from white patients.
Since BMI has been incorporated into health measurements for a long time, Wertz asked Thiara what different tools they might be able to use to determine if they are at a healthy weight.
While Thiara said that the BMI is still a good tool at the population level, she also said that it should not be the only tool used.
“The BMI is something that will probably be a part of your chart and your health care,” she said. “But what’s important to note is that there may be things about you as an individual where that BMI number does not really accurately predict whether or not you’re at risk for something like a heart attack or stroke or diabetes or other mechanical diseases associated with obesity, like arthritis and sleep apnea.”
Thiara also said doctors need to change not just the way they use BMI measurements, but the way they approach patient weight in general, and their understanding of obesity as a disease.
“Regardless of your specialty, you’re going to interact with a patient with obesity. You need to have obesity bias training,” she said. “You need to understand these limitations around BMI so that you care for your patient as an individual and don’t stigmatize them so they don’t feel comfortable returning to you.”
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