In a series of sweeping decisions that mark a significant shift in American healthcare policy, the American Medical Association (AMA) recently denounced the use of the body mass index (BMI) metric, stating that it has caused “historical harm” and has been used for “racist exclusion.”
Moreover, the AMA, a powerful lobby for physicians and medical students, announced its commitment to protecting “gender-affirming care” for transgender and gender-diverse individuals.
The AMA, founded in 1847, is a formidable force in American healthcare. As The New Yorker pointed out in 2022, the AMA’s lobbying expenditures since 1998 are surpassed only by the U.S. Chamber of Commerce, the National Association of Realtors, and the American Hospital Association.
American Medical Association says BMI metric caused 'historical harm' by being used for 'racist exclusion,' vows to protect 'gender-affirming care' for transgenders https://t.co/CzLABAL8C8
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The BMI, defined by the Centers for Disease Control and Prevention as a person’s weight in kilograms divided by the square of their height in meters, has long been used to screen for potential health issues related to weight. However, on June 14, the AMA issued a paper stating that BMI is imperfect because it does not directly assess body fat. The AMA Council on Science and Public Health underscored the complexity of interpreting BMI data due to numerous factors, including comorbidities, lifestyle, gender and ethnicity.
Controversially, the AMA House of Delegates adopted a policy that highlights the “historical harm” and use of BMI for “racist exclusion” on the basis that it was predominantly calibrated using data from non-Hispanic white individuals. Belgian mathematician Adolphe Quetelet developed the index in the 1830s using data from European white men, a fact cited by the AMA and others as proof of its “inherent bias.”
Former AMA president Jack Resneck Jr. noted the need for physicians to understand the limitations of BMI. He proposed using BMI with other measures such as body composition, waist circumference, and genetic and metabolic factors.
But the AMA’s initiatives did not end with BMI. Just days before the BMI announcement, on June 12, the AMA House of Delegates passed the Endocrine Society’s resolution to protect access to “evidence-based gender-affirming care” for transgender and gender-diverse individuals. The AMA called it the medical community’s responsibility to offer such care, especially in light of what it described as “increasing political attacks.”
The AMA’s commitment includes opposing criminal and legal penalties against patients seeking gender-affirming care, family members or guardians supporting them and healthcare facilities and clinicians providing such care. The AMA promises to work with federal and state legislators and regulators to challenge policies that undermine gender-affirming care.
In these decisions, the AMA pushes for a radical reassessment of traditional healthcare practices. Critics argue that these moves might be more rooted in social politics than medical evidence. As the medical landscape shifts in response to these policies, the true impact of these changes remains to be seen. Nevertheless, it’s clear that the AMA, wielding its considerable influence, has firmly thrust the intersection of medical science and “social justice” into the spotlight.