Beyond the BMI – Better Tools for Obesity Assessment

January 15, 2024

Historically, the most common weight evaluation tool has been the longstanding Body Mass Index (BMI). This rudimentary equation (a person's weight divided by height) was created in the 1800s to measure basic life expectancy and later adopted by life insurance companies in the 1900s to gauge if you were too heavy to safely insure. Surprisingly, in several healthcare circles, the BMI continues to serve as the baseline assessment for obesity today.

Originally designed to specifically measure the weight of white males, the BMI is nonetheless still used today to evaluate the weight of women, people of color, and the elderly. In other words, a 65-year-old Korean woman’s weight is evaluated based on an equation designed for white men. As a result, if you are a person of color or female, more than likely, your BMI does not accurately reflect your obesity risk or level. Thankfully, today, we have more accurate assessment measurements to help accurately diagnose obesity.

In June 2023, the American Medical Association (AMA) announced the adoption of a new policy recommending BMI be used only “in conjunction with other valid obesity risk factors, including measurements of visceral fat, body adiposity index, body composition, relative fat mass, waist circumference, and genetic/metabolic factors.”

Five more precise tools healthcare providers use to diagnose obesity 

A high-quality bariatric surgeon or obesity specialist will create a holistic evaluation of your weight and overall health based on several factors that extend far beyond a BMI number. Whether you are seeking an initial weight assessment or measuring the progress of your weight loss, these five assessments/measurements should also be used to precisely evaluate and measure your obesity risk:

Fat distribution is assessed by comparing your waist circumference to your hips. A higher ratio may indicate a higher risk of certain health issues.

Calculating your waist circumference in proportion to your height can offer insights into visceral fat levels, a key contributor to health risks.

Bariatric practices commonly provide these devices for in-office assessment. This non-invasive method assesses body composition by analyzing how electrical currents pass through different tissues.

Measuring the actual percentage of your body weight that comes from fat provides a more personalized assessment of the overall body composition.

Pre-diabetes and diabetes are common markers of obesity. Monitoring blood glucose levels during weight loss is a valuable marker for successful weight loss.

Combining Metrics for a Comprehensive Approach

The key to accurate obesity assessment (and monitoring) is to connect the results of various measurements beyond the BMI. Consulting with your healthcare provider about these methods empowers you to make informed decisions on your wellness journey.

It’s time to move beyond the outdated BMI and embrace a more holistic approach to obesity measurement. By combining various assessment tools, healthcare providers can offer personalized insights, ensuring a more accurate understanding of your health and supporting your path to well-being.

Dr. Seun Sowemimo is the medical director at Prime Surgicare and co-medical director of Central Jersey Bariatrics

ABOUT THE AUTHOR Dr. Seun Sowemimo is a board-certified laparoscopic, bariatric and general surgeon, specializing in the treatment of metabolic syndrome (obesity). He is the medical director at Prime Surgicare and co-medical director of Central Jersey Bariatrics, located in Freehold, NJ. Read more articles by Dr. Seun Sowemimo!

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