BMI: Invalid for Testing Individuals But for Large Populations…

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A column by Rick Osbourne

Despite widespread misgivings from the medical community (including the Mayo Clinic) BMI continues to be endorsed as the obesity measurement tool of choice by the CDC, the AMA, and the American Academy of Pediatrics, among others. It’s in fact a “yah but” kind of endorsement. In other words, they initially confess that BMI is invalid for testing individuals. But for mass testing purposes they contend, BMI is valid.



Now to pose the obvious question, why would BMI be invalid for one individual yet valid for a thousand or ten thousand individuals? A resounding silence is the only response I’ve ever heard to that question. This position actually compounds the confusion already surrounding obesity.

Conventional experts have identified many different causes and culprits for the ongoing obesity epidemic. But the one cause they inevitably overlook is BMI itself.


The One Overlooked Culprit is BMI

You’ll never hear a CDC employee say “If we’re unable to measure obesity changes accurately, how can we tell if an intervention is winning or losing?” You never see an AMA gatekeeper observe, “Oh my God, the emperor is wearing no clothes!”

The evidence is hiding right there in plain sight for all to see, yet the conventional community refuses to recognize it. In fact many of these bureaucrats are paid well to guard the gates and to ignore the problematic evidence, no matter how convincing. It’s enough to remind me of the old Groucho Marx quip, “Are you going to believe me or your lying eyes?”

There are plenty of culpable contributors to the childhood obesity epidemic. But none are quite as toxic as our failure to generate accurate feedback on body composition changes in the populations we want to study. BMI yields almost nothing of value when it comes to measuring and documenting changes in obesity.

In reality, BMI is little more than a pseudo-scientific sounding acronym that looks official, but whose real function is to confuse the conversation, buffalo the public, and to undermine any possible success in this ongoing, pervasive problem. Anyone who endorses BMI is actively endorsing failure. Yes, BMI is a huge part of the problem, not part of the solution.


Let’s Dump BMI
While it’s true that the three conventional alternatives to BMI (skin fold, electronic impedance, and hydrostatic weighing) are too labor intensive (i.e. too expensive*) to use in testing large populations, it’s EQUALLY UNTRUE that we lack an accurate and cost effective alternative to BMI. That said, one gigantic step in the right direction would be to DUMP BMI in favor of something that actually works. In this light check out a concept called FORE Score.

* BMI wins by default because it’s cheap on the front end. But for all the money saved up front, BMI has proven to be incalculably expensive on the back end due to its inability to distinguish between winning and losing interventions. This has cost trillions over the past two decades.


Rick Osbourne is a former physical educator and a pioneer in the field of functional childhood obesity prevention. He currently serves as President of the Pull Your Own Weight Foundation which is an Illinois based, 501c3, not for profit organization whose focus is functional childhood obesity prevention. He’s written and published three books in this field, the latest of which is entitled Beating Childhood Obesity Now: A Simple Solution for Parents and Educators. He’s the Examiner’s national childhood obesity prevention correspondent. He writes an online column for The Edvocate. And you can connect with Rick via Twitter, Linkedin, or Facebook.

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