Beyond BMI: How to Talk to Your Doctor About Health Metrics That Matter

Are you looking for an honest answer to a medical question? Dr. Mara Gordon, a family physician in Camden, N.J., answers reader health questions monthly. Write us at: [email protected].

Question: I’m sick of hearing about my weight when I go to the doctor. I’ve heard that body mass index isn’t even that helpful in determining how healthy I am, but my doctor still zones in on my BMI. What other metrics should my doctor and I be using to assess my health? 

It’s a common frustration for patients to feel their health is reduced to a number on a scale. Dr. Mara Gordon, a family physician, addresses this concern, acknowledging the limitations of relying solely on weight and BMI during medical checkups.

Unfortunately, it’s pretty common to meet doctors who focus on weight. As an anti-diet primary care doctor who takes a size-inclusive approach with my own patients, I often hear from people who feel belittled and shamed by this narrow focus on their body size.

“Every single time I would go into the doctor’s office, it was: ‘She’s overweight,'” Jessi Rice Greenlow told me. “‘You need to get her into sports. You need to reduce her food.'”

Now Greenlow is a health coach who helps families navigate weight stigma. But as a child, Greenlow said, every doctor’s appointment turned into a discussion about making her smaller.

“That shaped what our home life looked like and what I was allowed to think about myself,” Greenlow said.

Luckily, there are lots of other science-backed metrics you can focus on instead. In fact, BMI has some serious limitations when it comes to assessing how healthy you are.

When I work with my own primary care patients, I locate that focusing on more evidence-based metrics — including blood pressure, glucose tolerance, mobility, and mood — is much less stigmatizing. And it’s more scientific, too.

Beyond the Scale: What Metrics Matter

The conversation around health needs to shift. Focusing solely on weight can be detrimental, and a more holistic approach is crucial. Here’s a breakdown of key areas to discuss with your doctor, moving beyond the limitations of BMI.

The Limitations of BMI

In 2025, the Lancet published a major report on obesity, acknowledging that BMI provides “inadequate information about health at the individual level.” BMI is useful for population trends, but often too blunt for individual assessment.

The American Medical Association passed a resolution noting that BMI has “significant limitations” in clinical practice. Individuals with a “normal weight” can have advanced diseases, while others with higher BMIs can be thriving. Weight loss isn’t always positive, and can be a symptom of underlying illness.

Taking Control of the Conversation

You don’t have to be weighed at every appointment. A simple “I’d prefer not to be weighed” is often sufficient. Doctors may need weight for specific treatments (like chemotherapy dosing), but should explain why.

Greenlow suggests having “pocket phrases” ready to redirect the conversation. For example: “I’m not comfortable talking about my weight every appointment,” or “What else can we talk about?”

Prioritizing Your Health Goals

Focus on what *you* want to achieve for your health. What does a full, flourishing life appear like for you? This could involve adding vegetables to your diet, improving sleep, or increasing physical activity.

Greenlow recently found a doctor who asks about health goals and habits, rather than focusing on weight. She described it as a “new mental mindset” that allowed her to focus on positive changes, like getting better sleep.

Key Health Metrics to Discuss

Here are some critical areas to discuss with your doctor, beyond weight:

Mental Health: Many doctors screen for depression. Treatment options like therapy and medication can be very effective. Social connections are also vital for health and longevity.

Movement: Regular exercise is beneficial, but doesn’t need to be intense. Small “movement snacks” throughout the day can be effective. Assistive devices can help those with mobility limitations.

Sleep: Prioritize sleep as the foundation of overall health. Cognitive behavioral therapy for insomnia is an effective, medication-free treatment.

Cardiovascular Health and Glucose Tolerance

I test most of my patients for glucose intolerance, a precursor to diabetes, using a glucose test or Hemoglobin A1C. The A1C provides a picture of blood sugar levels over the past few months. Elevated A1C levels may warrant treatment or lifestyle changes like regular exercise.

Understanding your risk for cardiovascular disease is also crucial. Doctors often use risk calculators like the Athersclerotic Cardiovascular Disease Risk Estimator or the newer PREVENT calculator. A coronary calcium score can also provide additional information.

Cancer Screening

Ensure you’re up-to-date on recommended cancer screenings, including cervical, breast, and colon cancer.

Dr. Mara Gordon is a family physician in Camden, N.J.. She writes the Substack newsletter “Your Doctor Friend.”