Global health experts have called for redefining obesity to improve medical care and reduce stigma, according to a report in The Lancet Diabetes & Endocrinology. They propose categorising obesity into clinical obesity—for individuals whose weight causes health issues—and pre-clinical obesity—for those who are “fat but fit” but at risk of disease.
The report critiques the current reliance on Body Mass Index (BMI), which measures weight relative to height. While useful for population-level assessments, BMI has significant limitations. It does not distinguish between muscle and fat, nor does it reveal health conditions like heart problems or measure dangerous fat around the waist and organs.
“Obesity is a spectrum,” explained Professor Francesco Rubino of King’s College London, who chaired the expert group. “Some individuals with obesity maintain normal organ function, while others experience severe health issues.”
To improve diagnosis, the report recommends combining BMI with tools like waist circumference measurements, body fat analysis, and medical history reviews. This would ensure patients receive appropriate care and avoid unnecessary treatments.
With over a billion people living with obesity worldwide, demand for weight-loss drugs such as Wegovy and Mounjaro is soaring. These medications, which can reduce body weight by up to 20%, are typically prescribed to individuals with a BMI over 30 and related health conditions.
The redefinition could allow more targeted care for adults and children, said Professor Louise Baur from the University of Sydney, while reducing overdiagnosis. However, some worry about potential resource constraints for those in the “pre-clinical obesity” category.
The Royal College of Physicians praised the report, stating it provides a foundation for treating obesity with the same compassion and rigour as other chronic illnesses.
This nuanced approach aims to shift the focus from weight alone to overall health, improving patient outcomes and reducing stigma.
Source: BBCNews
