The BMI has its flaws, but still is the standard that medical researchers and some practicing physicians use. This may change shortly. There is a better and simpler way to predict the risk for cardiovascular disease than the BMI. Simply use the waist circumference.
1. BMI is falsely elevated in muscular individuals. BMI is falsely lowered in individuals with little muscle mass.
2.Bone structure can influence BMI. Larger framed individuals tend to have a higher BMI. The above finding helps explain why Asian-Americans, who tend to have smaller bone frames, have a higher disease risk at a lower BMI than people from other ethnic backgrounds.
3.The risk for vascular disease correlates better with fat in the abdominal area and not fat located distally in the arms and legs. The BMI does not take into consideration how bodyfat is distributed..
Not all insurance companies use BMI. I was once a medical underwriter for an insurance company and we never used the BMI.
There certainly is an obesity problem in the USA. You just need to observe people.
The following two studies were mentioned in a Medscape article discussing BMI versus waist circumference.
INTERHEART was the first large, international study to establish that obesity is a cardiovascular disease (CVD) risk factor that is statistically significant in basically all of the world's populations. Subsequent prespecified analyses of the INTERHEART results have further determined that a simple measure of waist-to-hip ratio is a more powerful predictor of obesity-associated CVD risk level than any other single measure of obesity (eg, body mass index [BMI]) or constellation of measures (eg, metabolic syndrome).
Now, a second large trial, the International Day for the Evaluation of Abdominal Obesity (IDEA) study, has also shown that waist circumference is a stronger predictor of CVD outcomes than BMI. First results of this large international study in over 170,000 people indicate that waist circumference is associated with CVD, independently of the relationship that BMI has with CVD risk, and regardless of age or geography