Body Mass Index - Usage

Usage

While the formula previously called the Quetelet Index for BMI dates to the 19th century, the new term "body mass index" for the ratio and its popularity date to a paper published in the July edition of 1972 in the Journal of Chronic Diseases by Ancel Keys, which found the BMI to be the best proxy for body fat percentage among ratios of weight and height; the interest in measuring body fat being due to obesity becoming a discernible issue in prosperous Western societies. BMI was explicitly cited by Keys as being appropriate for population studies, and inappropriate for individual diagnosis. Nevertheless, due to its simplicity, it came to be widely used for individual diagnosis, despite its inappropriateness.

BMI provided a simple numeric measure of a person's "thickness" or "thinness", allowing health professionals to discuss over- and under-weight problems more objectively with their patients. However, BMI has become controversial because many people, including physicians, have come to rely on its apparent numerical authority for medical diagnosis, but that was never the BMI's purpose; it is meant to be used as a simple means of classifying sedentary (physically inactive) individuals, or rather, populations, with an average body composition. For these individuals, the current value settings are as follows: a BMI of 18.5 to 25 may indicate optimal weight; a BMI lower than 18.5 suggests the person is underweight while a number above 25 may indicate the person is overweight; a person may have a BMI below 18.5 due to disease; a number above 30 suggests the person is obese (over 40, morbidly obese).

For a given height, BMI is proportional to mass. However, for a given mass, BMI is inversely proportional to the square of the height. So, if all body dimensions double, and mass scales naturally with the cube of the height, then BMI doubles instead of remaining the same. This results in taller people having a reported BMI that is uncharacteristically high compared to their actual body fat levels. In comparison, the Ponderal index is based on this natural scaling of mass with the third power of the height. However, many taller people are not just "scaled up" short people, but tend to have narrower frames in proportion to their height. Nick Korevaar (a mathematics lecturer from the University of Utah) suggests that instead of squaring the body height (as the BMI does) or cubing the body height (as the Ponderal index does), it would be more appropriate to use an exponent of between 2.3 and 2.7 (as originally noted by Quetelet). (For a theoretical basis for such values see MacKay.)

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