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Body Mass Index in Amputees

From the Medical Service and Dietary Service, Veterans Affairs Medical Center and Department of Medicine, University of New Mexico School of Medicine, Albuquerque

Annette Patron, MA, RD, CNSD

From the Medical Service and Dietary Service, Veterans Affairs Medical Center and Department of Medicine, University of New Mexico School of Medicine, Albuquerque

Deepak Malhotra, MD, PHD

From the Medical Service and Dietary Service, Veterans Affairs Medical Center and Department of Medicine, University of New Mexico School of Medicine, Albuquerque

Whereas estimates of percent deviation of body weight from ideal (Fweight) are corrected for amputation, those of body mass index (BMI) are not, creating discrepancies in evaluating obesity. A correction of the BMI formula for amputation is proposed. The formula for BMI was corrected for amputation mathematically. The mathematical model predicts that the uncorrected BMI formula underestimates body fat in unilateral amputees and overestimates body fat in subjects with bilateral amputations at the same length of the legs. Fweight and corrected and uncorrected BMI estimates were computed in 15 subjects with unilateral leg amputation and in 8 subjects with multiple amputations. BMI estimates were as follows: in unilateral amputees, corrected 24.1 ± 4.1 kg/m², uncorrected 22.2 ± 3.9 kg/m² (p < .001); and in multiple amputees, corrected 21.6 ± 2.4 kg/m², uncorrected 32.6 ± 11.8 kg/m² (p = .043). Linear regressions of Fweight obtained from standard nutrition assessment on Fweight computed from uncorrected and corrected BMI values were as follows: in unilateral amputees, uncorrected Fweight = -0.079 + 0.932 X actual Fweight, r = .974, p < .01, and corrected Fweight = 0.002 + 1.005 X actual Fweight, r = .997, p < .01; in multiple amputees, uncorrected Fweight = 0.528 + 1.930 X actual Fweight, r = .607, p is not significant, and corrected Fweight = -0.010 + 0.920 X actual Fweight, r = .936, p < .01. Uncorrected BMI estimates erroneously classified two obese unilateral amputees as nonobese and four lean or wasted multiple amputees as obese. A correction of the BMI formula for amputation is feasible. Corrected BMI estimates, in contrast to uncorrected estimates, agree with Fweight estimates. (Journal of Parenteral and Enteral Nutrition 18:355–358, 1994)

Journal of Parenteral and Enteral Nutrition, Vol. 18, No. 4, 355-358 (1994)
DOI: 10.1177/014860719401800414


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