Use of BMI in Clinical Practice—Co
mparison with Body Fat Measures
The use of the term “normal weight obesity” also
raises the question of how BMI was created for
use in epidemiological studies and clinical practi
ce and whether it was ever intended to predict per-
cent body fat. BMI requires only the measurement of
height and weight in the clinic and leads to
reasonable characterization as to wh
ether individuals are at lower or
higher risk for weight-related
complications [5]. Despite the avai
lability of very sophisticated im
aging techniques to measure per-
cent fat, regional fat distribution, lean tissue, etc.,
it turns out that BMI, when combined with a sim-
ple measure of fat distribution such as waist ci
rcumference, provides as good or better predictive
value for metabolic abnormalities
than does percent body fat [6]. BMI has been compared with per-
cent body fat as a way to define risk for metabolic abnormalities, and in general, BMI performs as
well as percent fat [7]. Unfortunately, neither
BMI nor percent body fat are exceptionally good pre-
dictors of the metabolic consequences of obesity
for most adults in the BMI categories below
~ 30 kg/m
2
[8]. Thus, while BMI and percent body fat ar
e correlated [7] and are both somewhat pre-
dictive of obesity-related health c
onsequences, neither is perfect
Use of BMI in Clinical Practice—Comparison with Body Fat Measures The use of the term “normal weight obesity” also raises the question of how BMI was created for use in epidemiological studies and clinical practice and whether it was ever intended to predict per-cent body fat. BMI requires only the measurement of height and weight in the clinic and leads to reasonable characterization as to whether individuals are at lower or higher risk for weight-related complications [5]. Despite the availability of very sophisticated imaging techniques to measure per-cent fat, regional fat distribution, lean tissue, etc., it turns out that BMI, when combined with a sim-ple measure of fat distribution such as waist circumference, provides as good or better predictive value for metabolic abnormalities than does percent body fat [6]. BMI has been compared with per-cent body fat as a way to define risk for metabolic abnormalities, and in general, BMI performs as well as percent fat [7]. Unfortunately, neither BMI nor percent body fat are exceptionally good pre-dictors of the metabolic consequences of obesity for most adults in the BMI categories below ~ 30 kg/m2 [8]. Thus, while BMI and percent body fat are correlated [7] and are both somewhat pre-dictive of obesity-related health consequences, neither is perfect
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