Experts Advocate for Comprehensive Approach Beyond BMI
Global medical leaders are urging a “radical overhaul” in diagnosing obesity, challenging the long-standing reliance on body mass index (BMI). While more than 1 billion people worldwide live with obesity, BMI, calculated from a person’s height and weight, is criticized for not accurately reflecting an individual’s health.
A report in The Lancet Diabetes & Endocrinology highlights how BMI’s inability to measure fat distribution or overall health has led to both under- and over-diagnosis, with harmful consequences. Experts propose adopting more precise diagnostic tools, including waist-to-height ratios and observable signs of ill health.
Clinical and Pre-Clinical Obesity Categories Proposed
The report introduces two new classifications:
- Clinical Obesity: Defined by reduced organ function or difficulty performing daily tasks, directly linked to excess body fat. Individuals would receive targeted treatments, including weight-loss medications.
- Pre-Clinical Obesity: Characterized by normal organ function but heightened future risk of diseases like type 2 diabetes and cardiovascular conditions. Preventative support would focus on reducing these risks.
Prof. Francesco Rubino, chair of the commission, emphasized that viewing obesity solely as a risk factor risks delaying care, while labeling all obesity as disease risks overdiagnosis and unnecessary interventions.
Reactions from Medical Organizations
Dr. Kath McCullough of the Royal College of Physicians welcomed the nuanced approach, stressing the need for early intervention. However, Katharine Jenner from the Obesity Health Alliance argued that supporting individuals with excess weight should remain the priority, rather than fixating on diagnostic methods.
This reframed definition of obesity could revolutionize patient care, ensuring tailored treatments that address individual health realities.
