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'It has limitations' | West MI doctor talks BMI after AMA clarifies its use in medicine

The American Medical Association recognizes issues with BMI due to historical harm, racist exclusion and how data was collected.

GRAND RAPIDS, Mich. — This month, the American Medical Association (AMA) adopted a policy to clarify how body mass index (BMI) is used as a measure in medicine.

The AMA looked at how the measurement has a problematic history due to "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."

Instead, the AMA suggests using BMI in conjunction with other measures such as measurements of visceral fat, body composition, waist circumference and more. 

"I think that it has its limitations," said Dr. Matthew Boutell, a family physician at University of Michigan Health-West, "We certainly are learning a lot now that it can both underestimate some patients and overestimate other patients."

Boutell said BMI does not take into consideration muscle mass or other health conditions to signal overall health. 

"It was actually designed by a person who was trying to determine the average size of a man," said Boutell, "I believe it was a somebody who was involved with the military in Europe, and he was looking for a way to kind of classify what the average soldier would be, your average person. So, it was certainly a male generated kind of measurement."

He said BMI is used as a screening tool, but not the "be all end all." He suggests a waist circumference measurement as a another tool to determine tendency for health problems such as diabetes, high blood pressure, heart disease and more. 

"What I'm stressing when I see patients in my office now is to say that it's not just that you need to eat less and exercise more, but we need to figure out is there a genetic factors," said Boutell, "Are there things that are in your body that are making it more difficult for you to make those changes? And can we tip the scale to kind of make it more effective for you to be living healthier and living better and really look at kind of a patient centered kind of approach to that rather than just identifying patients as obese or non obese, or giving them a number and saying, 'Okay, let's put you in that little box' kind of thing."

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