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'''Body Mass Index''' or '''BMI''' is a number calculated using height and weight, and sometimes gender or age (in children) that aims to measure whether someone's weight is within a healthy weight range, or if they are underweight, overweight or obese.<ref name="adult-BMI" /><ref name="definition" /> BMI values are used as a screening tool to aid diagnosis of certain illnesses, for example the presence or severity of [[anorexia nervosa]], and [[metabolic syndrome]], and to assess risk factors and demographic associations for many illnesses, and for some medical procedures.<ref name="adult-BMI" /> ==BMI chart == {{NeedsImage}} ==BMI ranges in adults == The United States [[Centers for Disease Control and Prevention|CDC]] uses these ranges for adults. For children and adolescents, alternative ranges are used.<ref name="BMI-table">{{Cite web | url = https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_tbl.htm | title = Body Mass Index Table 1 | last = | first = | author-link = | date = | website = National Heart, Lung and Blood Institute|archive-url=|archive-date=|url-status= | access-date = 2022-01-12}}</ref><ref name="adult-BMI">{{Cite web | url = https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html | title = Healthy Weight, Nutrition, and Physical Activity Section {{!}} About Adult BMI | last = | first = | author-link = | date = 2021-06-11 | website = Centers for Disease Control and Prevention|language=en-us|archive-url=|archive-date=|url-status= | access-date = 2022-01-11}}</ref> {| class="wikitable" |- ! BMI !! |- | Under 18.5 || Underweight |- | 18.5 - under 25 || Healthy weight |- | 25.0 - under 30 || Overweight |- | 30.0 - under 35 || Obesity class 1 |- | 35.0 - under 40 || Obesity class 2 |- | 40.0 or higher || Obesity class 3 (severe obesity) |} The [[Centers for Disease Control and Prevention|CDC]] regards a [[body mass index|Body Mass Index]] of 30 or higher in adults as obesity.<ref name="definition">{{Cite web | url = https://www.cdc.gov/obesity/adult/defining.html | title = Defining Adult Overweight and Obesity | last = | first = | author-link = | date = 2021-06-07 | website = Centers for Disease Control and Prevention|language=en-us|archive-url=|archive-date=|url-status= | access-date = 2022-01-11}}</ref> ==Criticisms== BMI evolved from an attempt to develop better health risk assessments for the United States health insurance industry than the height/weight tables used in the early 1900s, and were largely based on values for White adult men.<ref name="Nuttall2015">{{Cite journal | title = Body Mass Index: Obesity, BMI, and Health: A Critical Review | date = 2015 | url = https://journals.lww.com/nutritiontodayonline/fulltext/2015/05000/body_mass_index__obesity,_bmi,_and_health__a.5.aspx | journal = Nutrition Today | volume = 50 | issue = 3 | pages = 117–128 | last = Nuttall | first = Frank Q. | author-link = |language=en-US|doi=10.1097/NT.0000000000000092|pmc=|pmid=|access-date=|issn=0029-666X|quote=|via=}}</ref> In the 1990s, the [[World Health Organization]] adopted BMI as a medical measure and published ranges. Today BMI is widely regarded as as measure of "fat-ness" and has been found to contribute to both social stigma and bias or stigma from doctors and clinicans.<ref name="Nuttall2015" /> Key criticisms include: * the EPIC study of over 350,000 adults in Europe (aged 25 to 70) found that increased mortality was associated with a BMI of less than 21 or over 30, which is significantly different from the BMI ranges in use, men with a BMI of 26.5 had the lowest risk, similar results were found in the larger NIH–American Association of Retired Persons study * BMI is a relatively poor measure of fat-ness, and does not take into account waist circumference or muscle mass, it may assess some people with a high proportion of fat as in a healthy range and some with a healthy proportion as overweight or even obese * Older adults typically have reduced muscle mass, and higher amounts of fat, which means BMI may be too high for them<ref name="NHS">{{Cite web | url = https://www.nhs.uk/live-well/healthy-weight/bmi-calculator/ | title = BMI calculator {{!}} Check your BMI | last = | first = | author-link = | date = 2021-10-28 | website = National Health Service|language=en|archive-url=|archive-date=|url-status= | access-date = 2022-01-12}}</ref> * Mortality is often associated with a higher BMI, but a higher mortality in "wasting diseases" such as tuberculosis is associated with a lower BMI * Risk of developing [[diabetes]], [[metabolic syndrome]] and coronary heart disease has been found to be more closely associated with accumulated fat stores in the upper body than overall<ref name="Nuttall2015" /> ==Alternatives == A number of alternative measures exist that may be more accurate or provide additional information when screening for health risks: * waist circumference * abdominal/hip circumference ratio * skin-fold thickness measurements in different areas of the body * percentage body fat can be measured by underwater weighing, air displacement and density determination (using a Bod Pod), a bioelectrical impedance analyzer, and a determination of the isotopically labeled water mass * a DEXA x-ray scan can estimate fat accumulation around organs<ref name="Nuttall2015" /> ==Subgroup== ==ME/CFS== Body mass index is not considered a risk factor or an indicator for disease progression or for severity in ME/CFS - people with moderate ME/CFS typically have a higher BMI than those with severe ME/CFS.<ref name="Nacul2018">{{Cite journal | title = Hand Grip Strength as a Clinical Biomarker for ME/CFS and Disease Severity | date = 2018 | url = https://www.frontiersin.org/article/10.3389/fneur.2018.00992 | journal = Frontiers in Neurology | volume = 9 | issue = | pages = 992 | last = Nacul | first = Luis Carlos | author-link = Luis Nacul | last2 = Mudie | first2 = Kathleen | author-link2 = | last3 = Kingdon | first3 = Caroline C. | author-link3 = Caroline Kingdon | last4 = Clark | first4 = Taane G. | author-link4 = | last5 = Lacerda | first5 = Eliana Mattos | author-link5 = Eliana Lacerda | doi=10.3389/fneur.2018.00992|pmc=|pmid=|access-date=|issn=1664-2295|quote=|via=}}</ref> Studies looking at the small minority who have recovered from ME/CFS have not found BMI or any other factors predictive of recovery, except for short illness duration and milder illness.<ref name="Schur2007">{{Cite journal | title = Body Mass Index and Fatigue Severity in Chronic Fatigue Syndrome | date = 2007-01-01 | url = https://doi.org/10.1300/J092v14n01_07 | journal = Journal of Chronic Fatigue Syndrome | volume = 14 | issue = 1 | pages = 69–77 | last = Schur | first = Ellen A. | last2 = Noonan | first2 = Carolyn | last3 = Smith | first3 = Wayne R. | last4 = Goldberg | first4 = Jack | last5 = Buchwald | first5 = Dedra|doi=10.1300/J092v14n01_07|issn=1057-3321}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | author-link2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | author-link20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | author-link21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | author-link22 = John McLaren-Howard | last23 = Mena | first23 = I | author-link23 = Ismael Mena | last24 = Miwa | first24 = K | author-link24 = Kunihisa Miwa | last25 = Murovska | first25 = M | author-link25= Modra Murovska | last26 = Stevens | first26 = SR | author-link26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref> Most people with ME/CFS have a BMI in the healthy range, although obesity is relatively common in [[United States]] patients with ME/CFS.<ref name="UScoalition2020">{{Cite web | title = Diagnosing and Treating Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | last = U.S. ME/CFS Clinician Coalition |edition=2 | date = July 2020 | url= https://bridgesandpathways.org.au/wp-content/uploads/2021/02/DiagnosingAndTreatingMECFSV2_USCoalition_2020.pdf | pages = 4}}</ref> {{See also|Obesity}} ==Cost and availability== BMI is extremely easy to measure and calculate, and can be assessed by patients at home. ==See also== *[[Obesity]] *[[Metabolic syndrome]] *[[Healthy, balanced diet]] ==Calculators== *[https://extras.bhf.org.uk/patientinfo/bmi-v1.01/app/index.html BMI calculator with adjustments for ethnic group and gender] - British Heart Foundation *[https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html BMI calculator] - CDC *[https://www.mayoclinic.org/diseases-conditions/obesity/in-depth/bmi-calculator/itt-20084938 BMI and waist circumference calculator] - Mayo Clinic ==Learn more == *[https://www.washingtonpost.com/lifestyle/wellness/healthy-bmi-obesity-race-/2021/05/04/655390f0-ad0d-11eb-acd3-24b44a57093a_story.html Why BMI is a flawed health standard, especially for people of color] - Washington Post *[https://www.hsph.harvard.edu/obesity-prevention-source/obesity-definition/obesity-definition-full-story/ Why use BMI?] - Havard Health *[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469873/ In BMI We Trust: Reframing the Body Mass Index as a Measure of Health] - Social Theory and Health Journal ==References== {{reflist}} [[Category:Tests]] [[Category:Health measures]]
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