Doctors and health insurance companies began using the standard BMI chart in the early 1990s as a way to make a quick determination of how healthy a person is. Many doctors no longer feel that the BMI scale is an accurate measurement to use and that the medical field needs to find alternatives to BMI.
Today we are going to discuss the origin of the BMI scale and provide you with some information that demonstrates its flaws in accuracy and some better alternatives to BMI that many doctors now prefer.
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Where Did the BMI Chart Come From?
Almost 200 years ago, a Belgian mathematician named Adolphe Quetelet was working on a project for his job in the field of social statistics and population studies. The focus of his project was to look for patterns in the traits of humans to define the “average man” and to identify trends in body sizes within large groups of people. He developed an equation that he called the Quetelet Index, which used a person’s height and weight as a tool for statistical analysis to identify trends related to the proportions of an average human body and was never designed to measure body fat or determine someone’s health status.
An American physiologist named Ancel Keys published a study in 1972 using Adolphe Quetelet’s equation and called it body mass index, stating that it was a better way to assess body weight relative to a person’s height. Then in the 1980s and 1990s, organizations like the World Health Organization and the National Institute of Health decided to use this old equation to create the body mass index (BMI) chart that is still used today.
What Does the BMI Chart Look Like?
This is a sample of an expanded BMI chart that shows the standard categories as well as the classifications of obesity.
We Need a Better Universal System
A person’s BMI number is calculated using their height and weight, and then they are put into a category on the BMI chart. One of the biggest drawbacks of using the BMI chart as a benchmark is that it is not a true representation of the individual's health, yet major decisions are made using this number.
In the early 1990s, when the NIH and WHO developed the BMI chart that we use today, life insurance agencies began using it to make decisions regarding risk assessment. Then, the NIH published recommendations for surgery eligibility using the BMI scale, which led to medical insurance companies using it to make decisions regarding eligibility for approving or denying coverage for a procedure or surgery.
The BMI chart is still being used today to make major decisions regarding health, medical procedures, and sometimes even determining an individual's financial coverage or insurance options while being questionably inaccurate.
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What Are the Drawbacks of the BMI Chart?
The BMI chart is not an accurate reflection of how much excess body fat an individual is carrying or the state of their health. Some of the reasons we need to find an alternative to BMI include:
Muscle vs. Fat
When calculating BMI, only the individual's height and weight are used, and it does not take into consideration how much muscle mass is present. Muscle weighs more than fat, so anyone who is athletic, like a football player, and possesses a significant amount of muscle mass would be classified as obese or overweight and considered unhealthy even though they are not carrying an abundance of excess fat.
Ethnic Differences
When Adolphe Quetelet developed his initial equation for his statistical analysis purposes, it was based on Caucasian men, so this equation does not account for any differences in body composition for people who are of other ethnic groups. For example, a person of Asian descent might have a higher body fat percentage but a lower BMI than someone of Italian descent, who has a higher BMI but not much extra fat due to higher bone density and more muscle mass. BMI alone does not always provide an accurate measurement of body fat percentage.
Age And Gender
BMI is calculated universally for everyone regardless of their gender, age, ethnic background, etc. Women normally carry more fat, and men usually have more muscle mass, and fat is usually distributed differently between the two genders. Also, as people get older, their body composition tends to change, but there is no room in the BMI calculation to account for these differences.
Other Health Issues
The equation that determines an individual's BMI only considers their weight and height and does not take into account things like blood pressure or cholesterol readings, their family history, lifestyle habits, or other elements that would be a better indicator of their general health.
Your BMI number might be helpful as a starting point, but it should not be used as the only benchmark to determine your eligibility to undergo certain treatments or surgeries or as a tool to calculate your insurance premiums.
What Is a Better Alternative to BMI?
Many doctors are now using alternatives to BMI that give them a more accurate picture of how much excess fat an individual is carrying. Some better alternatives to BMI include:
1. Waist Circumference
The volume of visceral or abdominal fat present can be assessed by measuring the circumference of the individual's waist. This type of fat is often referred to as the “bad fat” because it is associated with a higher risk of serious health conditions like type 2 diabetes and heart disease.
2. Body Adiposity Index (BAI)
The body adiposity index estimates your percentage of body fat by using a calculation involving your height and the circumference of your hips. Research has reported that in some populations BAI can be a more accurate representation of body fat than BMI.
3. WHR (Waist-to-Hip Ratio)
The WHR method uses a calculation that divides
the circumference of your waist by the circumference of your hips. A high WHR would indicate that your body is storing a higher concentration of fat in your midsection, which would mean a greater risk for serious health issues like heart disease. Some studies have proven WHR to be more accurate in predicting mortality risks than the BMI scale.
4. Bioelectrical Impedance Analysis (BIA)
This is a scan that is done using a low level of electrical current that is sent through your body to determine its composition, including the percentage made up of fat vs. lean mass. Today some scales have built-in BIA calculators that are designed for at-home use that are pretty accurate if used correctly. It is important to follow the directions carefully because things like your hydration level can throw off the results.
5. Skinfold Thickness
This method involves using calipers to measure the thickness of skinfolds in certain places on your body. It takes a bit of skill and knowledge to do it the correct way, but for someone who knows what they are doing, it can be a very quick process and a much more accurate measure of how much body fat you are carrying than using the BMI chart.
6. DEXA Scans
A Dual-Energy X-Ray Absorptiometry or DEXA scan gives you detailed images of your body composition and includes readings on your bone density, percentage of fat, and lean mass. They are extremely detailed and accurate, but they are expensive and not normally easy to access.
What Should I Use Instead of BMI to Find My Body Fat Percentage?
A BMI chart can give you a quick idea of how you stand as far as your weight is concerned, but it is not accurate enough to give you an idea of how healthy you are or how much excess body fat you are carrying.
Dr. Steven Batash and his knowledgeable team at Batash Endoscopic Weight Loss Center can help you understand your body composition and the level of excess body fat you are carrying. They will create a safe plan tailored for your exact needs and provide the support you need to help you reach a healthy weight.
Batash Endoscopic Weight Loss Center offers several non-surgical weight loss tools and strategies that can help you overcome both past and present challenges. They can help you develop healthy habits that promote weight loss and are sustainable in the long-term so you can maintain your results.
Contact Batash Endoscopic Weight Loss Center today and set up your personal consultation to get started!
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