The global report calls for a more precise definition of obesity than BMI

There is a danger that too many people are diagnosed with obesity when a more “precise” and “nuanced” definition is needed. global expert report he says

Doctors should consider the general health of obese patients, rather than measuring their body mass index (BMI), he says.

Those with chronic diseases due to weight should be diagnosed with “clinical obesity”, but those without health problems should be diagnosed with “preclinical obesity”.

It is estimated that more than a billion people are living with obesity worldwide and prescription weight loss drugs are in high demand.

The report, published in The Lancet Diabetes & Endocrinology, is endorsed by more than 50 medical experts from around the world.

“Obesity is a spectrum,” says Professor Francesco Rubino, from King’s College London, who led the team.

“Some people have that and manage to live a normal life, function normally.

“Others can’t walk or breathe well, or are wheelchair-bound with significant health problems.”

The report calls for a ‘reframing’ of obesity to distinguish between patients who have a disease and those who remain healthy but are at risk of developing disease in the future.

Today, in many countries, it is defined as being obese A BMI over 30 – Measurement that calculates body fat based on height and weight.

Access to weight loss drugs such as Wegovy and Mounjaro is often limited to patients in this category.

In many parts of the UK, the NHS also requires people to have a weight-related health condition.

But BMI doesn’t reveal anything about a patient’s overall health, the report says, and doesn’t distinguish between muscle and body fat or take into account the more dangerous fat around the waist and organs.

Experts advocate a new model that examines the signs of obesity affecting the body’s organs – such as heart disease, shortness of breath, type 2 diabetes or joint pain – and their detrimental impact on daily life.

This indicates that obesity has become a clinical disease and requires drug treatment.

Those with “preclinical obesity,” however, should be offered weight loss advice, counseling and monitoring instead of medication and surgery to reduce the chances of developing health problems. Treatment may also be necessary.

“Obesity is a health risk; the difference is that for some it is a disease,” said Professor Rubino.

Redefining it made sense, he added, to understand the level of risk for a large population, instead of the current “blurry picture of obesity.”

A waist-to-height ratio or direct fat measurement, along with a detailed medical history, can provide a much clearer picture than BMI, the report says.

Professor Louise Baur, a childhood obesity expert at the University of Sydney who contributed to the report, said the new approach would allow obese adults and children to “receive more appropriate care”, while reducing the number of people who are overdiagnosed and given unnecessary treatment. .

At a time when drugs that reduce body weight by up to 20% are being prescribed on a large scale, the report says that this “reformulation” of obesity is “even more important” because it “improves the accuracy of the diagnosis”.

The Royal College of Physicians said the report laid a strong foundation for “treating obesity with the same medical rigor and compassion as other chronic diseases”.

Differentiating between preclinical and clinical obesity would be “an essential step forward” and “highlights the need for early identification and intervention” by providing appropriate care to patients with severely compromised health, the university said.

But there are concerns that pressure on health budgets could mean less money for those in the “pre-obese” category.

Professor Sir Jim Mann, co-director of the Edgar Diabetes and Obesity Research Center in Otago, New Zealand, said the emphasis on “the needs of those clinically defined as obese” and limited funding was “very likely”. likely” to target them.