Use and Misuse of BMI Categories

Area of Science:

• Medical history
• Public health
• Obesity studies

Background:

• Body mass index (BMI) originated in the 19th century as a height-weight ratio.
• Overweight and obesity were not widely viewed as population health risks until the late 20th century.
• The development of weight loss drugs in the 1990s spurred the medicalization of BMI.

Purpose of the Study:

• To analyze the historical medicalization of body mass index (BMI).
• To evaluate the health outcomes and societal impacts of classifying obesity as a disease.
• To examine the effectiveness of BMI-centric approaches to weight management.

Main Methods:

• Historical analysis of medical and governmental classifications of BMI and obesity.
• Review of policy changes regarding obesity treatment reimbursement.
• Examination of research on the health benefits and harms associated with BMI categories and weight loss interventions.

Main Results:

• The World Health Organization and US government adopted BMI-defined obesity categories in 1997.
• Policy changes in 2004 enabled reimbursement for weight loss treatments.
• The American Medical Association recognized obesity as a disease in 2013.
• Current evidence indicates limited health benefits from BMI focus and potential for weight-related discrimination.

Conclusions:

• The medicalization of BMI and obesity has accelerated since the late 20th century.
• Despite its classification as a disease, the focus on BMI and weight loss has not yielded significant health improvements.
• Weight-centric approaches contribute to discrimination and other adverse effects, necessitating a re-evaluation of obesity management strategies.