Body mass index has been the standard measure for classifying obesity and overweight for several decades. Some find it useful, while others believe the BMI scale is inaccurate. And in the United States, a rather controversial decision has now been made. Because during its annual conference in June this year, the American Medical Association (AMA) asked its members to no longer use the BMI scale in clinical treatment. At least not to the same extent as before. This association represents the vast majority of doctors in the country. – There are many concerns about the way BMI has been used to measure body fat and diagnose obesity. It is important for physicians to understand both the benefits and limitations of the scale. It’s about finding the best treatment for the patients, says former AMA president Jack Resneck in a press release. The criticism is, among other things, that the scale does not take account of the fact that body shape and composition vary across origins, ethnic groups, gender and age. What is BMI? Body mass index (BMI), defined as body weight divided by height times height (kg/m2). Underweight: Lower than 18.5. Normal weight: 18.5 – 24.9. Overweight: 25 – 29.9. Obesity: 30 – 34.9. Severe obesity: 35 – 39.9. Very severe obesity: 40 -> This is criticized The American Medical Association has published a separate report in connection with the new regulations. Here they write, among other things, that the BMI scale does not differentiate between fat and other body mass. And that it also does not take into account where on the body the fat is located. Studies have shown that fat that accumulates around the stomach can be more dangerous than fat on the thighs. Therefore, the association believes that measuring the circumference around the waist, or measuring the ratio between waist and hip, can be just as useful. Something the group particularly emphasizes is that the scale does not take into account one’s origin. So ancestry and genetics. For example, studies have shown that Asian, Hispanic and African-Americans have a higher risk of developing type 2 diabetes at a lower BMI than white people. The report also noted that BMI is not a good way to catch people with eating disorders. But if all this is true, why has this scale been so widely used over so many years? Is BMI (body mass index) something you relate to? Yes, I know where I am on the scale No, it’s not something I think about Show result Disagree – BMI is strongly correlated to total body fat mass and also the simplest and best indirect measure of body fat mass we have, also at an individual level. That’s what obesity expert Jøran Hjelmesæth says to news. He works as a section chief in the hormone, obesity and nutrition department at the Hospital in Vestfold. In addition, he is a professor at the University of Oslo. Hjelmesæth therefore believes that BMI should be retained as a clinical measure of degree of obesity before, during and after weight reduction treatment. The expert is nevertheless clear that the scale has some limitations. Body Mass Index or body mass index (BMI), is a medical tool that measures the ratio between height and weight to estimate the amount of body fat. Photo: Ørjan Totland / news – It may therefore be useful to carry out other supplementary investigations that can say more about the location of the fat mass. For example, by measuring waist circumference, especially in those with overweight or obesity degree 1. Marte Kvittum Tangen is head of the Norwegian Association for General Medicine (NFA). She believes the Americans are onto something. Want more knowledge The leader of the general practitioners says the BMI scale is often used in Norwegian doctors’ offices. – This is, among other things, about reimbursement for drugs in obesity treatment. That is based only on BMI, she says to news. Tangen thinks the change in the US is exciting. – I find this very interesting. It is known that BMI does not say everything about the risk of obesity, and that there are large individual differences. It also does not take muscle mass or physical form into account. The doctor believes that we must gradually gain more knowledge about what the biggest risk factors for obesity and overweight are. And that you have to get better at making individual assessments. – We lack knowledge. Because the vast majority of studies in this area are based precisely on BMI. Marte Kvittum Tangen is head of the Norwegian Association for General Medicine. She believes that most GPs in Norway would have been positive to relate less to the BMI scale. Photo: Thomas B Eckhoff / The Norwegian Medical Association Slimming drugs The debate around the use of BMI has flourished as a result of new slimming drugs, writes Scott Hagan. He is an assistant professor of medicine at the University of Washington. Both in this country and in the USA, diabetes medicine is used among the obese. Examples of these are Wegovy and Ozempic. Here, your body mass index determines whether you are eligible to receive these medications or not. In the US, BMI is also decisive for which life insurance people get. It may also have something to say about which medical treatment you have access to. Such as fertility treatment. But even if the BMI scale has its limitations, there are several who believe that it will be difficult to ignore completely. One of the reasons is that there are not many other methods to measure body fat. In addition, it costs nothing to use. – Beyond BMI and waist measurement, we have no simple or better methods for measuring the mass of body fat. In that case, you have to use more advanced equipment that is mostly only used for research, says Jøran Hjelmesæth.
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American doctors are asked to use the BMI scale to a lesser extent – news Trøndelag
