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American Medical Association adopts new policy on healthy weight assessment

The American Medical Association has revised its guidance on determining healthy weight, advising doctors to consider factors beyond body mass index due to limitations.

The American Medical Association (AMA) on Wednesday said it will advise doctors to pay less attention to body mass index (BMI) in determining if a patient is at a healthy weight, saying the measure does not predict disease risk equally well across racial and ethnic groups.

BMI, a ratio of weight to height, has long been used to define underweight, "normal" weight, overweight, obesity and morbid obesity, despite mounting evidence that it is an inaccurate predictor of health risks on an individual level.

At the influential physician group's annual meeting in Chicago, members voted adopt a new policy that says BMI should be just one factor in determining whether a patient is at a healthy weight. Other measures such as body composition, belly fat, waist circumference, and genetic factors are also important, the AMA said.

There have been "issues with using BMI as a measurement due to its historical harm (and) its use for racist exclusion," the AMA said.

In its announcement on Wednesday, the AMA acknowledged that the BMI scale is based primarily on data from white people, while body shape and composition vary among racial and ethnic groups, genders, and age groups.

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Weight problems have long been attributed to poor lifestyle decisions, such as eating too much due to lack of willpower.

Views on proper weight, and on causes of obesity in particular, have begun to change along with new approaches to management, including effective, new weight loss drugs such as Wegovy from Novo Nordisk.

At the other extreme, the AMA said "overemphasis of bodily thinness is as deleterious to one's physical and mental health as obesity." It asks doctors to help patients "avoid obsessions with dieting and to develop balanced, individualized approaches to finding the body weight that is best for each of them."

The AMA's new policy also says BMI should not be used as a sole criterion for denying insurance reimbursement.

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