By Joy Stephenson-Laws, JD, Founder 

I’ve been saying this for years. Measuring body mass index (BMI) is not the best method to assess whether a person is at a healthy weight. BMI is simply your weight in kilograms or pounds divided by the square of your height in meters or feet. To easily calculate your BMI and see what category you fall under (underweight, normal weight, overweight, obesity) click here to use the tool provided by the National Heart, Lung, and Blood Institute (a branch of the NIH).

The American Medical Association (AMA) recently adopted a new policy regarding how BMI plays a role in measuring obesity. Body composition data, which will tell you how much muscle, fat and water your body contains, is far more important than BMI. When you use BMI as a comprehensive tool for measuring obesity across all populations, you are buying into one of the biggest misconceptions this country has had when it comes to attempting to tackle America’s obesity crisis.

“Under the newly adopted policy, the AMA recognizes issues with using BMI as a measurement 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,” the AMA shared in a press release discussing the new policy.

In the 1800s, a Belgian mathematician and astronomer named Adolphe Quetelet gathered a couple hundred Belgians and weighed and measured them, eventually concluding that the BMI equation was representative of the standard human build. Since then, doctors have applied BMI to individual patients. Male, female, muscular, tall, short -- everyone gets measured the same way. Clearly, this is not inclusive of the many different racial and ethnic groups present in the world today.

“Due to significant limitations associated with the widespread use of BMI in clinical settings, the AMA suggests that it be used in conjunction with other valid measures of risk such as, but not limited to, measurements of visceral fat, body adiposity index, body composition, relative fat mass, waist circumference and genetic/metabolic factors.”

Basically, BMI should be supplemental to more inclusive as well as individualistic methods.

To give you even more perspective, just about a month ago there was a report published about how one in three Asian Americans has diabetes and doesn’t even know it. 

“Most healthcare providers use the body mass index (BMI)—a person’s weight divided by their height—as a way to assess diabetes risks.1 But the standard BMI measures may be unable to reflect diabetes and obesity risks in Asian Americans accurately,” according to the report.

“Asian Americans tend to have higher fat distributions but lower muscle mass compared to other ethnic groups, and their body weight might be lower as a result, according to Caroline Ong, MD, MS, a cardiologist at Lenox Hill Hospital in New York.”

I’m sure most of you have heard the expression skinny fat. A skinny fat person will most likely pass the BMI test with flying colors, but if this person took a body composition test or perhaps measured their belly fat they would likely discover that they are not in fact healthy and are at risk for metabolic issues such as type 2 diabetes and heart disease. 

Belly fat may be a sign of unhealthiness.

Some belly fat is okay, but if  you have a potbelly or are carrying a lot of extra weight in the abdominal area, this is a big red flag. This is visceral fat which grows deep inside the stomach and may wrap around your vital organs. It may also increase your risk of developing diabetes and fatty liver disease.

Many Americans do carry visceral fat due to following the Standard American Diet, also known as the SAD diet. This diet is rich in processed and ultra-processed foods and does not include nearly enough fresh fruit and vegetables as well as nuts (and other healthy fats from sources such as avocado), legumes and healthy, lean proteins. In my opinion, following a nutrient-dense diet with whole foods is the most effective way to combat visceral fat. Of course, working out helps but it’s really hard to outrun or outtrain a poor diet that is heavy in calories and lacks nutrients and fiber.

Body adiposity index (BAI).

Many have heard of BMI but not BAI. Body adiposity index measures body fat percentage. 

“The method, called the Body Adiposity Index (BAI), uses hip circumference and stature measurements in a simple mathematical equation [BAI = hip circumference (cm)/height (m)1.5 – 18], and has proven to be practical, easy, fast, and low cost,” according to a report from Advances in Nutrition and published by Oxford Academic.

“The advantages of the method make it an interesting alternative to laboratory methods for evaluating body composition in epidemiologic studies or clinical practice, especially for identifying overweight or obesity in individuals, which is currently one of the most serious public health problems in the world.”

So if you are going to do the math, I highly suggest calculating your BAI as opposed to BMI. With that said, I still strongly encourage undergoing a body composition test in addition to a comprehensive nutrient test. Most of us are not nutritionally balanced, and not having an adequate intake of all the vital vitamins and minerals can actually contribute to weight gain or make weight loss particularly challenging. If the test reveals you are not nutritionally balanced, a competent healthcare practitioner can work with you on making the necessary dietary changes and recommend quality supplements if necessary.

Maintaining a healthy weight and body composition is so much more than how we look. It’s about happy and healthy longevity. If we can achieve a healthy weight and fat to muscle ratio, the more likely we are to avoid joint issues and serious chronic issues such as diabetes, heart disease, hypertension and even dementia and depression.

Enjoy your healthy life!

Disclaimer: This article is not intended to provide medical advice. Please consult with your doctor or another competent healthcare practitioner to get specific medical advice for your situation.                            

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses, and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products, and services. To learn more about the pH Medical Advisory Board, click here.