Should BMI Be Adjusted for Race?

You Should Know: BMI is a notoriously inaccurate health measure. It can’t tell muscle from fat or figure out where exactly fat sits in the body. Plus, it was developed about 200 years ago using only bodies of white European men. Some researchers and clinicians are now pushing for race- or ethnicity-sensitive BMI cutoffs to uncover risk sooner in groups the standard number skips over.

Going Deeper: The WHO suggested lower BMI cutoffs for Asian populations over 20 years ago, after data showed people of South and East Asian descent often develop metabolic disease at lower BMIs than the global cutoff catches. A recent Atlantic piece is bringing the debate back, though. Critics note broad labels like “Black” or “Asian” minimize big differences across ancestry, diet, geography, and family history, and that race-based medicine has led to discrimination against patients before.

Takeaway: Both standard and race-adjusted BMI try to reduce a complicated human body down to just one number, and that’s the root of the issue.

Bottom Line: Until waist-to-hip ratio or body fat percentage are standard measurements, BMI should be used as an approximate data point in a full health workup.