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Useful for Some Patients
43%

43% of clinicians find BMI imperfect but consider it useful, depending on the patient

BB | Betsy B, Family Practice

“BMI can be helpful but has its limitations. For inactive people who have excess fat, it is accurate regarding risks of DM, HTN. Its limitations and inaccuracy come with people who are fit and strong with more muscles than fat. Then BMI may say they are overweight when they are not. It can also lead thin people with excess abdominal fat to think they are healthy when their BMI is in the normal range, but their abdominal circumference is large. So, I am starting to focus more on the abdominal circumference for many patients.”

AT | Alexandra T, Family Practice

“BMI is great to get a quick sense of the patient's degree of obesity. However, some patients who are technically obese may have a high muscle mass. They may be in good overall health, eat healthily, and exercise regularly. Others may not. We can use BMI as a starting point and then stratify patients further based on comorbidities.”

GW | Gerald W, Family Practice

”BMI is a tool that cannot be universally applied. I have many patients whose BMI is in the overweight or obese range but have extraordinary muscle and bone mass, which skews the numbers.”

Not Accurate or Reliable
32%

32% warn that BMI is outdated and inaccurate, though payors make its use unavoidable

TP | Tracy P, Family Practice

“No, it is not reliable it is a very jaded look at the patient. Unfortunately, it is part of the vital signs and used by insurances to determine which patients might benefit from certain procedures and medications. It also unfortunately causes many people to get sleep studies to maintain their CDL."

PT | Petra T, Family Practice

“BMI is a flawed measure – it does not incorporate muscle mass and bone mass. With muscular individuals, it gives very misleading info! Unfortunately, it is very widely used and creates lots of unnecessary anxiety among patients.”

SB | Susan B, Family Practice

“We need a better measurement of health than the BMI. First, it doesn't measure muscle mass or conditioning of a person. Having been at the finish line many times waiting for my spouse to finish a marathon, it always amazed me on how many finishers of the 26-mile race appear overweight or even obese. Ultra-thin people are not any healthier than an average weight person, in fact without extra weight post-op for surgeries are at higher risk for death and post op complications.”

Accurate and Reliable
24%

24% are confident in the accuracy of BMI and rely on it daily for all patients

RS | Rahman S, Family Practice

“I tend to use BMI daily, especially when initiating weight loss meds and certain med approvals depend on the BMI. I educate patients in their BMI and what category it puts them in on a daily basis. I utilize it because it is a fairly simple measurement to take in the office.”

PC | Peggy C, Family Practice

“I use BMI with every patient rather than words of overweight or obesity. I think it is a good predictor of overall health."

GC | Gustavo C, Family Practice

“I use it daily. We discuss their progress in weight loss or gain and give ranges for goals.”

Use Waist-Hip Ratio / Body “Roundness” Scale
10%

10% discussed the benefits of waist circumference as an alternative to BMI

JN | Jamie N, Family Practice

“I've always been frustrated with BMI. BMI does not account for differences in gender, muscle composition and body type. I consistently find muscular men are obese according to BMI. Waist circumference is more reliable. Fat composition and distribution are what matter.”

KN | Kanakasabai N, Endocrinology

“Easy to use tool in clinical practice. Has its limitations. Helpful in assessing obesity / overweight especially in association with chronic disease states. More beneficial if used with waist circumference.”

WK | William K, Cardiology

“I'm intrigued by the body 'roundness' index. Inputs are just height, some demographics (race, sex), and waist circumference. The problem I have with it is that is a very complicated equation, which is tough to calculate on my own. Also, we don't currently measure waist circumference in clinic (it wouldn't be hard to do but would certainly feel even more invasive than having a patient hop on the scale at the start of a visit).”

Use BMI to Reinforce Lifestyle Improvements
9%

9% leverage BMI as a gateway to start conversations about weight with their patients

BH | Brent H., Family Practice

“I think discussion of the BMI metric is the start of the conversation regarding holding a healthy weight...it is by no means the only thing that matters. There are very healthy people who have an elevated BMI and very unhealthy people who have a normal BMI.”

LV | Lauren V, Family Practice

“BMI is one of many measures that I use with my patients to assess risk factors for certain health conditions, and I find the results can be a gateway to discussing diet/ lifestyle/ exercise changes with patients who need them.”

PH | Phedra H., Family Practice

“I do use BMI with patients. I feel it is easier for communication with patients concerning the delicate topic of weight. For example, instead of saying 'you are obese,' I use 'your BMI is elevated.' I feel this is much less judgmental.”

Source: Healthcasts HCP Community, Clinical Question #3792, n=481 clinicians. Summarized September 2024. 

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