A new report from the Lancet Global Commission calls for a shift in how we diagnose obesity, urging the use of more accurate measures like waist circumference and waist-to-hip ratio, alongside the traditional body mass index (BMI). This report, published in The Lancet Diabetes and Endocrinology journal, aims to address the limitations of using BMI alone to determine obesity.

Why BMI is no longer enough

Current medical practices tend to mainly use BMI to decide on issues such as health levels and a patient's risk factor of disease, but BMI would hardly give one the correct interpretation of an individual's healthiness or risk of getting diseased. The authors maintain that this tends to lead to the wrong diagnosis regarding someone's health, perhaps with adverse results for those diagnosed as living with obesity.

BMI cut points, for example, a score of more than 30 was defined as obese, were established based on data largely from individuals of European origin. The report indicates that country-specific measures can be used to tailor these classifications based on ethnicity, better-capturing obesity risks for different populations. Experts, including some from India, contributed to this new approach.

A new way to classify obesity: Clinical and Pre-Clinical

The report introduces two new categories that will help to diagnose obesity: clinical obesity and pre-clinical obesity.

Clinical obesity involves individuals whose obesity has already resulted in chronic conditions or organ dysfunction associated with obesity.

Preclinical obesity indicates a higher health risk from obesity, but the development of disease is not yet seen.

According to Francesco Rubino, the Commission chair from King's College London, explained, “The question of whether obesity is a disease is flawed because it presumes an implausible all-or-nothing scenario where obesity is either always a disease or never a disease." He added that while some people with obesity remain healthy for years, others experience serious health problems much sooner.

How this new approach can help in healthcare

This new definition gives way to more customized care, allowing health care practitioners to serve patients appropriately. For those who fall under the category of clinical obesity, it ensures getting the treatments right on time. For those pre-clinically obese, it is about strategies to avoid potential future health risks.

Rubino thinks this shift will ensure that healthcare resources are prudently directed and where they are most needed treatments are prioritised.

Impact of obesity at global level

It has been estimated by the World Health Organization that, in 2022, over one billion people across the globe lived with obesity. Obesity is much more than an issue of physical health and leads to numerous complications, such as heart diseases, metabolic disorders, and even cancer. Moreover, it has a bearing on bone health, fertility, sleep, and even mobility.

This new report on obesity diagnosis could change the way we understand and manage this global health challenge, ensuring that individuals receive the right care at the right time.