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Body mass index (BMI) is the cornerstone of the current classification system for obesity and its advantages are widely exploited across disciplines ranging from international surveillance to individual patient assessment. However, like all anthropometric measurements, it is only a surrogate measure of body fatness. Obesity is defined as an excess accumulation of body fat, and it is the amount of this excess fat that correlates with ill-health. We propose therefore that much greater attention should be paid to the development of databases and standards based on the direct measurement of body fat in populations, rather than on surrogate measures. In support of this argument we illustrate a wide range of conditions in which surrogate anthropometric measures (especially BMI) provide misleading information about body fat content. These include: infancy and childhood; ageing; racial differences; athletes; military and civil forces personnel; weight loss with and without exercise; physical training; and special clinical circumstances. We argue that BMI continues to serve well for many purposes, but that the time is now right to initiate a gradual evolution beyond BMI towards standards based on actual measurements of body fat mass.

Original publication

DOI

10.1046/j.1467-789x.2001.00031.x

Type

Journal article

Journal

Obes Rev

Publication Date

08/2001

Volume

2

Pages

141 - 147

Keywords

Adipose Tissue, Aging, Body Composition, Body Constitution, Body Mass Index, Body Weight, Continental Population Groups, Exercise, False Positive Reactions, Humans, Military Personnel, Obesity, Sports, Weight Loss