Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Is measuring Body Mass Index (BMI) obsolete?

James Haddad
Conditions
July 15, 2012
Share
Tweet
Share

I’ve been interested in health and nutrition since I started playing high school sports.  During my 3 year stint as a personal trainer, I developed a distinct opinion of the Body Mass Index (or BMI – the most widely used anthropomorphic measurement in medicine):  it’s not a very good tool.

My issue with BMI began here – it doesn’t actually measure a person’s body fat or lean mass, but rather is an assessment of an individual’s weight and how it deviates from what has been determined ‘normal’ for his or her height.  People come in all shapes and sizes, and my clients were no exception.  You may have heard the argument that BMI doesn’t apply to athletes, for example.  I, myself, met the strict criteria for “overweight” (BMI>25) during my brief foray into amateur bodybuilding.  So I abandoned BMI calculations and instead used body fat percentages as goals for my clients.

A study published this April in PLoS One assessed the utility of BMI, DXA scans (typically used to assess bone mineral density), and serum leptin levels when measuring an individual’s adiposity.  Researchers concluded that BMI misclassified 25% of men and 48% of women – the effect was exaggerated in older individuals (likely because individuals lose both height and lean body mass as they age).  The authors suggest that use of DXA and leptin measurements “offers the opportunity for more precise characterization of adiposity and better management of obesity.”  This is where our opinions part ways.

Using DXA scans and leptin measurements to assess adiposity in patients would be unnecessarily costly and invasive (and DXA scans pose yet another source of radiation exposure patients simply don’t need).  Given the widespread availability and improved accuracy of bioimpedance devices, point-of-care testing of body fat percentage is made not only simple to implement, but would be cost-effective in any primary care office.

Now, the virtues of the BMI are that it’s a simple, easy-to-calculate, low-tech means of assessing a patient’s body habitus, and it provides a standardized format for physicians to use.  However, skinfold calipers are also cost-effective.  Bioimpedance devices, while not as accurate as calipers, may be a quick, cost-effective way to more accurately describe and track a patient’s body fat, and they don’t require any experience to operate or interpret.  They also provide a means of describing body composition in a way that patients are more likely to understand.

Wouldn’t it be great if you could have a personalized measurement of your lean and non-lean body masses?  A meaningful number you could track as you diet and exercise?  Many of my clients and patients have been discouraged when their weight doesn’t change, or even increases, when they implement a diet and exercise plan – it can be hard to explain to them that body composition is more important than weight!  Likewise, patients may find body fat percentage easier to relate to than the esoteric BMI.

The reality is, BMI won’t be going anywhere for the time being, but it would be interesting to see these alternatives tested in clinical practice to determine if they can in fact help patients improve their body compositions.

James Haddad is a medical student who blogs at Abnormal Facies.

Prev

MKSAP: 25-year-old woman with bloating and abdominal cramping

July 15, 2012 Kevin 1
…
Next

5 reasons that prevent doctors from using mobile apps

July 15, 2012 Kevin 2
…

Tagged as: Obesity, Primary Care

Post navigation

< Previous Post
MKSAP: 25-year-old woman with bloating and abdominal cramping
Next Post >
5 reasons that prevent doctors from using mobile apps

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by James Haddad

  • a desk with keyboard and ipad with the kevinmd logo

    Will a shift to longitudinal experiences improve medical education?

    James Haddad
  • a desk with keyboard and ipad with the kevinmd logo

    Bearing the burden of the uphill battle against childhood obesity

    James Haddad
  • a desk with keyboard and ipad with the kevinmd logo

    Nutrition needs to be taught in medical school

    James Haddad

More in Conditions

  • What if medicine had an exit interview?

    Lynn McComas, DNP, ANP-C
  • Finding healing in narrative medicine: When words replace silence

    Michele Luckenbaugh
  • Why coaching is not a substitute for psychotherapy

    Maire Daugharty, MD
  • Why doctors stay silent about preventable harm

    Jenny Shields, PhD
  • Why gambling addiction is America’s next health crisis

    Safina Adatia, MD
  • How robotics are reshaping the future of vascular procedures

    David Fischel
  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • Adriana Smith’s story: a medical tragedy under heartbeat laws

      Nicole M. King, MD | Physician
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • Adriana Smith’s story: a medical tragedy under heartbeat laws

      Nicole M. King, MD | Physician
    • What if medicine had an exit interview?

      Lynn McComas, DNP, ANP-C | Conditions
    • Why U.S. health care pricing is so confusing—and how to fix it

      Ashish Mandavia, MD | Physician
    • From survival to sovereignty: What 35 years in the ER taught me about identity, mortality, and redemption

      Kenneth Ro, MD | Physician
    • When doctors forget how to examine: the danger of lost clinical skills

      Mike Stillman, MD | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • Adriana Smith’s story: a medical tragedy under heartbeat laws

      Nicole M. King, MD | Physician
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • Adriana Smith’s story: a medical tragedy under heartbeat laws

      Nicole M. King, MD | Physician
    • What if medicine had an exit interview?

      Lynn McComas, DNP, ANP-C | Conditions
    • Why U.S. health care pricing is so confusing—and how to fix it

      Ashish Mandavia, MD | Physician
    • From survival to sovereignty: What 35 years in the ER taught me about identity, mortality, and redemption

      Kenneth Ro, MD | Physician
    • When doctors forget how to examine: the danger of lost clinical skills

      Mike Stillman, MD | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Is measuring Body Mass Index (BMI) obsolete?
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...