The Body Mass Index (BMI) is not an EBP Tool
Katerina Raiser, Tara Cooke, Olivia Dalrymple, Erin McNamara, Christina Gyarmati, Addison McInnes
Drexel University College of Nursing and Health Professions
The Problem:
BMI Scale
What do you see?
BMI:
•  is an outdated formula, developed nearly 200
years ago based only on the formula:
(weight (kg) / [height (m)]2)
• is not a measurement of adiposity
• may lead to misclassification of persons with
normal levels of fat as being overweight or even
obese
Misclassification due to the BMI formula may
overestimate mortality, morbidity and disability risks and
health insurance costs. This formal is also underidentifying those at risk of developing weight-related
health problems such as cardiovascular disease or
hypertension. There is currently limited to no studies
testing the BMI scales diagnostic accuracy across
different populations.
Are there alternatives?
Keywords and Search Engines Utilized
- Body mass
- Index
- Inaccuracies
- Body composition
- Standardized
- Percentile
- Adiposity
- Misclassifications
- Height
- Weight
- Obesity
Pubmed, CINAHL, LexisNexis
Does this make sense?
Why isn’t this EPB?
• BMI ignores factors that affect adiposity
including greater muscle mass and
sacropenic obesity in women leading to a high
rate of misclassifications
• Compared to DXA direct measurement of
percent body fat, BMI significantly misses a
large portion of the obese population resulting
in DXA and leptin levels being a much more
accurate representation of obesity
• BMI has an extreme limited ability to people
falling in the intermediate BMI range leading
to a misrepresentation of 50% of people with
excess fat
TEMPLATE DESIGN © 2008
www.PosterPresentations.com
GAMLSS
• Generalized Additive Models for Location, Scale
and Shape
• Requires extensive surveying including… hours
of TV watched per day, maternal BMI, smoking
during pregnancy, etc.
• Complex statistical methodology is involved
• Relies on accurate patient recollection of health
history and tendencies
Skin-Fold Thickness
• Additional training required to utilize
measurement devices (Skinfold calipers)
• Expense of devices needed to perform
measurement
• Comfort of clients undergoing measurement is
not a strong point
• Accuracy of measurement relies on ability of
person performing measurement
Nursing Implications
Education
• Being able to obtain an accurate indicator of
healthiness related to body fat will aid nurses in
providing correct education about dieting/eating habits to
patients
• Through incorrectly identifying some individuals, nurses
are not educating individuals who may benefit from
education related to healthier eating or increasing weight
• By correctly identifying individuals who are not in a
healthy range in relation to body fat, nurses will be able
to educate clients about co-morbidities and other related
problems
Practice
• Using a non EBP tool is not clinically helpful to patients.
• It is important that clinicians use tools that are most
accurate and evidence based
• There is a need to practice with tools that will have the
best outcome for patients.
Research
• Through utilizing nurses to complete research to find an
alternative to the BMI, nurses will be able to test the new
scale and determine how useful, accurate, and beneficial
it is
• More research related to finding a more useful scale
other than the BMI will allow individuals to pursue a
healthier life style and may be able to lengthen the life
span of individuals
References
• .
Is this truly more accurate?
Jitnarin N., Poston W.S.C., Haddock C.K., Jahnke S., and Tuley B.C.
(2012). Accuracy of body mass index-defined overweight in fire fighters.
Occupational Medicine, (63), 227-230.
Kyle U.G., Schutz Y., Dupertuis Y., and Pichard C. (2003). Body
Composition Interpretation: Contributions of the Fat-Free Mass Index and
the Body Fat Mass Index. Nutrition, 19(7/8), 579-604.
Romero-Corral A., Somers V.K., Sierra-Johnson J., Thomas R.J., CollazoClavell M.L., Korinek J., Allison T.G., Batsis J.A., Sert-Kuniyoshi F.H., and
Lopez-Jimenez F. (2008). Accuracy of body mass index in diagnosing
obesity in the adult general population. International Journal of Obesity,
(32), 959-966.
Shah N.R. and Braverman E.R. (2012). Measuring adiposity in patients:
the utility of body mass index (BMI), percent body fat, and leptin. PLoS
ONE, 7(4): e33308.doi:10.1371/journal.pone.0033308