A group of 58 researchers have challenged the traditional definition and diagnosis of obesity, arguing that current methods do not fully capture the complexity of the condition. In a revised definition published in The Lancet Diabetes & Endocrinology, they propose a more nuanced approach that focuses on how excess body fat, known as adiposity, affects the body rather than relying solely on body mass index (BMI).
The researchers suggest two categories: preclinical obesity, where a person has extra body fat but their organs function normally, and clinical obesity, where excess fat harms the body’s organs and tissues. This new approach could lead to improvements in clinical care, public health policies, and societal attitudes towards obesity, according to Elisabeth van Rossum, an endocrinologist at the Erasmus University Medical Center Rotterdam.
Obesity is a global problem affecting more than 1 billion people worldwide and is linked to approximately 5 million deaths each year from conditions such as diabetes and cardiovascular disease. While BMI has been a commonly used tool for diagnosing obesity due to its ease of measurement and comparison, it does not provide a comprehensive view of a person’s health as it does not account for variations in body composition.
The researchers propose a more comprehensive system for diagnosing obesity that includes factors such as waist circumference, body scans using low-level X-rays to measure fat mass, and other health markers like waist-to-hip ratio or waist-to-height ratio. They emphasize the importance of personalized assessments that consider age, gender, and ethnicity, as certain groups may face health risks at lower BMI thresholds than others.
The new approach also distinguishes between preclinical and clinical obesity, with the former focusing on preventive measures and lifestyle changes to reduce the risk of developing serious health issues, while the latter may require treatments aimed at improving health and preventing complications. This approach is particularly relevant given the increasing use of weight-loss drugs, as it can lead to more accurate diagnoses and effective treatment plans.
Despite the support from scientific and patient-advocacy groups, there is still a stigma surrounding obesity that hinders individuals from seeking care. Many health-care providers still view obesity as a matter of willpower rather than a disease driven by excess fat, which underscores the need for better education and communication about the condition.
While it remains to be seen how this new approach will impact the diagnosis and management of obesity in clinical practice, the researchers hope that it will eventually be integrated into clinical practice guidelines. Overall, this revised definition of obesity offers a more accurate and comprehensive understanding of the condition, paving the way for improved healthcare outcomes and societal perceptions.
