Bmi, Universal Reference Or Dethroned Index? Credibility Of Bmi In Obesity Alternatives To Body Scanning For The Diagnosis Of Obesity

Abstract

Objective: We studied the relevance and limitations of the Body Mass Index (BMI) the universal corpulence indicator. Its formula, established by Mr. Quetelet, a Belgian mathematician in 1832, is BMI = Weight/Height² [kgm^-2]. This metric utilizes a uniform scale, independent of gender, age or race. The following are threshold values: below 18 [kgm^-2] for underweight, 18 to 25 [kgm^-2] for healthy weight, between 25 and 30 [kgm^-2] for overweight, and obesity if BMI is above 30 [kgm^-2]. Given the increasing prevalence of obesity and its complexity, how much credibility can we  still give to this two-century-old index?

Method: This bibliographical review recalls some definitions and obesity epidemiological data. We then retrace the history of the BMI its use and limitations. We recount the questions and concerns of some clinicians and experts, who have become reluctant to diagnose a chronic disease as complex as obesity, on the basis of a simple formula that was established more than 200 years ago, and  still used today without any changes!

Conclusion: BMI widely used in clinical practice, scientific research and population studies runs the risk of under-diagnosing the adverse health effects of obesity. Experts recommend clinical monitoring of "toxic" waist circumference. The outcome of this literature review argues in favor of body exploration using more accurate, simple and inexpensive techniques, such as bioimpedancemetry-BIA, and the adoption of a new body mass index focusing on trunk fat mass and cardiometabolic risk.