Although some form of the BMI pre-dated today’s version by many years, it really came into popular use in medicine in the early 1970’s. It is undeniable that the BMI is imperfect as a measure of healthy versus unhealthy weight. It may underestimate overweight/obesity in the elderly with diminished lean body mass and may overestimate it in a heavily muscled, young person. Doctors know this and use the BMI as one tool, and often not even the most important one, when clinically evaluating patients. To say it is racist, however, is a step much too far.
I could not help myself, and sent this letter to Ms. Kelly Jakubek, the Public Information Officer of the AMA:
I would ask you to kindly forward this email to as many members of the AMA Leadersip as you can.
Just when I thought the AMA could not sink further, you prove me wrong. As if embracing gender-affirmation treatment in children and adolescents and avowing that medicine is systemically racist were not enough, the AMA now embraces a truly unscientific position vis a vis the use of BMI in medicine. As a practicing plastic surgeon for over thirty three years, I use a BMI chart daily when discussing surgery with patients. In step with the overall demographics of the US population, over two thirds of my patients are overweight or obese. Like most physicians, I know these when I see them with a high level of confidence. This poses well known and abundantly documented challenges and risks to surgery, not to mention their long term overall health. I make it clear that this is not a moral issue but rather a strictly medical one and I advise them accordingly. I also make it clear that BMI is not the sole arbiter of health risk. Race never enters into it. Most of my patients are white.
Any physician worthy of the title knows that the BMI charts we routinely use are imperfect but serve as a ueseful tool with which to counsel patients I know as well as anyone that a muscular individual with little body fat may register as obese on this chart. Medical education is intended to teach us to take into account all aspects of the clinical presentation of the patient before us. Your stance assumes otherwise and is an insult to physicians. Further, to claim that it is racist is ludicrous and laughable, or would be but for the toxic division such baseless accusations have already fomented in our country. I know an overweight or obese patient when I see one. If you really want to be helpful, rather than virtue-signaling your obeisance to the race hustlers, you might fund some research to improve the utility of the BMI charts. Just a suggestion.
I don’t know what committee or individuals came up with this position, but they are clearly following an ideological agenda that has nothing to do with evidence-based or good patient care. They need to be disbanded or, better yet, sent back to medical school as they clearly learned nothing the first time around.
I left the AMA in disgust during the Presidency of Barack Obama due to its failure to properly represent physicians during the deliberations regarding the Affordable Care Act, which I and many of my peers regard as nothing less than a thinly veiled attempt at total government takeover of healthcare. Nothing since has suggested it was not intended to do just that. Using Medicaid to solve the problem of the uninsured is a sad joke and confirms that those behind the ACA had no intention of resolving insurance discrepancies.
The AMA has ceased to have any relevance to me and the other 85% of physicians in America who are not members. It would serve us all best for the AMA to shut down and quietly go away. You have done enough harm to patient trust in organized medicine and it will require generations to recover this, if it can be recovered.
Shame on you for your abrogating your responsibility to physicians and the patients we serve.
I suspect Ms. Jakubek will do what any representative of an organization will do upon receiving such a letter: she will delete it and go on about her day. Even so, I had my say.
R. T. Bosshardt