Workforce Health + Benefits

BMI: An Imperfect Measure

There have been several industry articles about the fact that measuring body mass index (BMI) alone fails to capture a true picture of health. A new study released by the Annals of Internal Medicine examines the associations of BMI and body fat percentage (separately and together) with mortality.

Their press release states that keeping body fat low as you age is more important than achieving a low number on the scale…Both low BMI, a measure of a person’s weight in relation to height, and high body fat percentage are independently associated with increased risk for death.¹

It goes onto say that this topic has become a source of debate as physicians have all been advised to counsel obese patients to lose weight to decrease their risk for chronic conditions, such as diabetes and heart disease.¹

The findings of this study suggest that body composition, not just weight, should be considered when assessing an individual’s health and risk of death. In some cases, higher BMI may actually reflect non-fat tissue such as muscle.¹

Bravo has historically recorded BMI as our measure of obesity related to health risk. That being said, we are aware that BMI is an imperfect measure and encourage program participants who receive a problematic score to have a conversation with their personal provider. If their provider can confirm that the high BMI was a result of lean muscle mass, then that participant passes the goal.

It is our recommended best practice to also record a waist circumference—if a person has a failing BMI but a waist of 35 inches or less for males or 33 inches or less for females they too will pass the goal without having to go through our appeals process. We can work with clients to customize passing measurements specific to their population.

Dr. Joseph Berley, Bravo’s Consulting Medical Director, states, “Based upon this study, BMI alone should be considered an insufficient measurement of an individual’s overall health status. That makes sense as I have always believed BMI is a simple measurement which requires more definition in order to be applicable to a particular patient, and additional measurements such as epicondylar width and/or waist circumference are also important in determining an individual’s body mass.”

Bravo intends to evolve as more information becomes available concerning this matter but for now, under the recommendation of Dr. Berley, we intend to continue offering BMI in conjunction with waist circumference. And in the meantime, our appeals process allows for any participant’s biometric screening measurements to be appropriately challenged through consultation with their personal provider.

To watch a video summary of the research study conducted, click here.



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