BMI is part of a range of clinical screening and gatekeeping practices, but historical and current uses reinforce inequity and exclusion.

Healthist views about body shape and weight are oppressive and lead to pernicious harms, especially to members of vulnerable groups. 

Weight loss is not a safe, effective, or permanent method of health promotion, and pharmacotherapeutical approaches pose specific risks to adolescents. 

Use of body mass index as a health care metric is controversial, especially in candidacy assessments for gender-affirming surgery.  

Physicians tend to rely on diagnostic criteria, including BMI, that can influence patients’ access to care, referrals, and insurance coverage for indicated interventions. 

Although body-mass index is regularly used, it has come under clinical and ethical scrutiny. 

Despite concerns about clinical outcomes for patients with obesity, clinical trials report few data about such patients.

Underlying ideological foundations of stigma and equipment inadequacy include thin-centrism and inadequate representation of fat people in health care organizational leadership.  

Size-based health and beauty ideals emanated from eugenic pseudoscientific postulates, and BMI continues to advance white supremacist embodiment norms. 

Diagnostic utility of weight and body mass index is widely overestimated, and their use as health and wellness measures can be sources of iatrogenic harm. 

While useful in analyzing population trends in relative body weight, BMI possesses multiple shortcomings when used as an individualized health screening tool.

Before the late 20th century, overweight and obesity were not considered population-wide health risks, but the advent of weight loss drugs in the 1990s accelerated hypermedicalization via BMI use. 

In the early 20th century, the United States, as an industrialized nation with more food than ever, began to grapple with obesity.

Editorial Fellows Astrid Floegel-Shetty and Kratika Mishra join Ethics Talk to discuss the development of this month’s theme issue on medicine’s overreliance on BMI, and fat stigma researcher Ragen Chastain talks about how patients can be harmed by BMI surgical guidelines and what to do if it happens to you.

Dr Madeline Ward joins Ethics Talk to discuss her article: “Why We Need to Stop Labeling Behaviors Influencing a Person’s Weight Ideal or Healthy."

Dr Jake Young joins Ethics Talk to discuss his article: “AMA Code of Medical Ethics’ Opinions Related to Clinical Use of BMI.”

Dania Pagarkar joins Ethics Talk to discuss her article, coauthored with Drs Erin Harrop and Lisa Erlanger: “How Should We Approach Body Size Diversity in Clinical Trials?”

Jorie Braunold joins Ethics Talk to discuss her article: “Fat Norms and the AMA.”