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BMI is worthwhile as a long-standing way to gauge health risks. However, its limitations have sparked a growing trend of criticism. Developed over 200 years ago based on an overwhelmingly White male data sample, BMI doesn’t even consider differences in age, sex, ethnicity, or body composition. For instance, an Olympic-level athlete could easily find himself categorized as “obese” because muscle weighs more than fat, while the person with metabolic syndrome may seem” healthy” with underlying lurking risks.
The limitations of BMI
In 2023, the American Medical Association (AMA) highlighted the historical misuse of BMI and recommended that it ought to be used in conjunction with other metrics, such as visceral fat and waist circumference, for a more comprehensive evaluation of health issues. The visceral fat is set deep around organs. Visceral fat is directly linked with such ailment conditions as heart disease, type 2 diabetes, and Alzheimer’s. However, given that BMI alone critically depends merely on weight and height, its simplicity has afforded it a place in clinical practices.
Introducing the Body Roundness Index (BRI)
Emerging as a promising alternative, the Body Roundness Index (BRI) incorporates waist and hip measurements relative to height, offering a nuanced view of body shape and fat distribution. Developed in 2013, BRI ranges from 1 to 16, with higher scores indicating rounder midsections. Studies suggest BRI is a better predictor of disease risk, especially conditions linked to central obesity, such as cardiovascular issues and certain cancers.
A 2024 study analyzing 33,000 U.S. adults found a U-shaped correlation between BRI and mortality risk, with both high and low BRI scores associated with increased death rates. Unlike BMI, BRI reflects demographic variations, which is critical for underdiagnosed groups like Asian populations, who may carry more visceral fat at lower BMIs.
Despite its potential, BRI faces challenges in replacing BMI. Health systems have deeply integrated BMI into practices like growth charts and drug dosing. Experts, including BRI’s creators, suggest using both indices for a fuller health assessment.
While advanced body composition scans offer the most precise analysis, their cost and inaccessibility limit widespread use. For now, BRI provides a more refined tool, but its adoption must address patient concerns around weight stigma and ensure a supportive clinical environment.
