For decades, Body Mass Index (BMI) has been the standard for diagnosing obesity, but a new report from The Lancet Diabetes & Endocrinology challenges its accuracy, urging the medical community to adopt broader assessment criteria.
As reported by economictimes, the commission recommends that obesity diagnoses be confirmed using at least one additional measurement, such as waist circumference or direct body fat analysis. The move addresses BMI’s limitations as a sole indicator of obesity.
BMI calculates the ratio of a person’s height to their weight to estimate body fat, with a BMI of 30 kg/m² or above typically classifying someone as obese. However, the report highlights that individuals with excess body fat may not always exceed this threshold, potentially leaving health risks undetected. Conversely, people with high muscle mass, such as athletes, may have elevated BMIs despite normal fat levels, leading to misclassification.
Revisiting Obesity Metrics
Dr. Robert Eckel of the University of Colorado Anschutz Medical Campus explains that fat distribution significantly impacts health risks. “Excess fat stored at the waist or around vital organs like the liver and heart poses higher health risks than fat stored under the skin in areas like the arms or legs. Yet, some individuals with unhealthy fat levels may not have a BMI indicating obesity, leaving their issues unnoticed,” he said.
Indian expert Dr. Anoop Misra added that abdominal obesity is prevalent in India, yet often overlooked by BMI-based criteria. “The new classification will address this gap,” he noted.
New Classification of Obesity
For the first time, the Lancet Commission proposes subdividing obesity into two categories:
- Clinical Obesity: Characterized by visible signs of altered organ function or impaired daily activity, requiring medical or surgical intervention.
- Preclinical Obesity: Where no such symptoms exist, treatment may not be necessary, with regular monitoring and health counseling sufficing in many cases.
The commission emphasizes that not all obesity cases require immediate intervention, focusing on tailoring care to individual health risks. Left untreated, obesity can lead to severe complications, including increased risks of heart attacks and strokes.
This paradigm shift in obesity assessment aims to improve early detection and ensure that interventions are more precise and equitable, enhancing outcomes for patients worldwide.