Why BMI is not the obesity measurement we need
ISLAMABAD: A global panel of experts has proposed a groundbreaking approach to diagnosing and managing obesity, moving beyond the traditional reliance on Body Mass Index (BMI), which has notable limitations.
The new framework introduces advanced methods for identifying and understanding obesity, such as distinguishing between pre-clinical (early signs) and clinical (advanced) stages of the condition. This innovative approach aims to improve healthcare outcomes for over one billion people living with obesity globally, reduce stigma, optimise the use of medical resources, and ensure equitable access to effective treatments.UK expertise to support 7 innovative Pakistani climate change projects
The recommendations, published in The Lancet Diabetes & Endocrinology and supported by over 75 medical organisations worldwide, advocate for incorporating additional measures of excess body fat alongside BMI. These measures also include identifying specific health issues and symptoms linked to obesity in individuals.
This refined framework seeks to redefine how obesity is diagnosed and addressed. It also addresses the shortcomings of traditional diagnostic methods, which have often hindered individuals with obesity from receiving adequate care and support.
Aiming to clarify the ongoing debate, global experts have proposed a clear and evidence-based method to diagnose obesity, which they hope will help resolve the question of whether obesity should be classified as a disease.
Researchers stressed that labeling obesity as either always a disease or never a disease oversimplifies the issue, as evidence points to a more nuanced understanding.
They highlighted that while some individuals with obesity maintain normal organ function and good overall health, others suffer from significant symptoms and health complications linked to the condition.
The researchers warned that viewing obesity merely as a risk factor, rather than a disease, could limit access to timely care for individuals whose health is adversely affected by obesity.
On the other hand, labeling obesity as a disease for everyone could lead to overdiagnosis, unnecessary treatments, and high costs, which would burden both individuals and society.
The new framework offers a more nuanced approach, acknowledging that obesity is a complex condition and advocating for personalized care tailored to the unique needs of each individual.
- For individuals with clear signs of obesity (clinical obesity): The framework recommends timely and effective treatments, similar to the management of other long-term health conditions.
- For individuals at risk of obesity (preclinical obesity): The focus would be on reducing risks and preventing the progression of the condition before it develops into more serious health issues.
With over 1 billion people worldwide estimated to be living with obesity, the Commission’s proposal presents an opportunity for health systems to adopt a universal and clinically meaningful definition of obesity, along with a more accurate diagnostic method.
The current methods of diagnosing obesity are viewed as outdated and ineffective, and there is often disagreement among doctors and policymakers about their reliability. This is because these methods can lead to errors, such as inaccurately measuring body fat or misdiagnosing obesity-related health issues.
A key issue lies in the overreliance on Body Mass Index (BMI), which is commonly used to define obesity as a BMI over 30 kg/m² for individuals of European descent. Many countries also apply specific BMI thresholds to adjust for ethnic variations in obesity-related risks.
While BMI can help identify individuals who are at higher risk for health problems, the Commission stresses that BMI is not a direct measure of body fat, and it should not be the sole factor in diagnosing obesity.
BMI fails to account for fat distribution in the body and provides no insight into an individual’s overall health or the presence of any underlying illness.
The researchers emphasized that the health risks associated with excess fat depend on where the fat is stored in the body. For example, fat stored around the abdomen may carry higher health risks compared to fat stored in other areas, such as the hips or thighs. Therefore, relying solely on BMI overlooks these crucial factors and can lead to inaccurate diagnoses.
