Affiliate at Stanford Research Center in Palo Alto, California.
AMA J Ethics. 2023 Jul 1;25(7):E550-558. doi: 10.1001/amajethics.2023.550.
Body mass index (BMI) was introduced in the 19th century as a measure of weight relative to height. Before the late 20th century, overweight and obesity were not considered a population-wide health risk, but the advent of new weight loss drugs in the 1990s accelerated the medicalization of BMI. A BMI category labeled obesity was adopted in 1997 by a World Health Organization consultation and subsequently by the US government. Language in the National Coverage Determinations Manual stating that "obesity itself cannot be considered an illness" was removed in 2004, allowing reimbursement for weight loss treatments. In 2013, the American Medical Association declared obesity to be a disease. Yet the focus on BMI categories and on weight loss has yielded few health benefits and contributes to weight-related discrimination and other potential harms.
体重指数(BMI)于 19 世纪作为一种衡量体重与身高相对关系的指标引入。在 20 世纪后期之前,超重和肥胖并不被认为是一种全人群健康风险,但 20 世纪 90 年代新的减肥药的出现加速了 BMI 的医学化。1997 年,世界卫生组织的一次咨询会议采用了 BMI 类别中肥胖的标签,随后美国政府也采用了这一标签。2004 年,《国家医疗保险覆盖决定手册》中“肥胖本身不能被视为一种疾病”的措辞被删除,从而允许对减肥治疗进行报销。2013 年,美国医学协会宣布肥胖为一种疾病。然而,对 BMI 类别和减肥的关注几乎没有带来健康益处,反而导致了与体重相关的歧视和其他潜在危害。