A group of international experts has proposed a significant change in how we define and diagnose obesity. Their new approach suggests that we should move away from relying solely on the body mass index (BMI), a method that many consider controversial, and instead, incorporate additional measurements like waist circumference and health issues related to excess weight.
Currently, over a billion individuals worldwide are estimated to be affected by obesity, with around 40% of adults in the United States fitting this classification, as reported by the Centers for Disease Control and Prevention.
Dr. David Cummings, an obesity expert at the University of Washington and one of the authors behind this new report, emphasizes that these changes aim to create a more precise definition in order to effectively identify those who truly need medical assistance.
The report introduces two new categories for better understanding obesity: clinical obesity and pre-clinical obesity. Clinical obesity includes individuals who meet both the BMI and other obesity-related markers, showing tangible health issues stemming from their weight. These health problems could include heart disease, hypertension, liver or kidney disease, or severe joint pain. People in this category would qualify for different treatment options, including dietary changes, exercise programs, and obesity medications.
On the other hand, pre-clinical obesity refers to those who may be at risk for these conditions but do not currently exhibit any ongoing health problems.
For years, BMI has been criticized as an unreliable assessment tool, often misdiagnosing individuals who may not have significant health issues associated with their weight. The current threshold for obesity is a BMI of 30 or greater, but this does not account for those with high muscle mass, such as athletes, who may also fall into the higher BMI range without having excess body fat.
Under the new guidelines, preliminary findings suggest that around 20% of individuals previously classified as obese would no longer fit this definition, while an equal percentage of those experiencing severe health challenges but maintaining a lower BMI could now be categorized as clinically obese.
While Dr. Cummings stated that these changes wouldn’t drastically alter the obesity statistics, they would enhance our ability to identify individuals who genuinely face serious health risks due to excess fat.
More than 75 medical organizations worldwide have supported these updated definitions. However, it is unclear how quickly and effectively they will be implemented in healthcare practices. The report does acknowledge that putting these recommendations into action could be costly and may require significant workforce adjustments.
A representative for the health insurance industry has indicated that it’s too soon to predict how insurance plans will adapt to these new standards.
Experts have pointed out several practical challenges. For instance, measuring waist circumference may seem straightforward, but varying protocols and a lack of proper training among healthcare providers can complicate matters. Additionally, standard medical tape measures may not accommodate larger individuals, which could present further difficulties.
Dr. Katherine Saunders, an obesity specialist, highlighted that distinguishing between clinical and pre-clinical obesity will necessitate thorough health assessments and lab tests. For the new system to gain widespread acceptance, it needs to be efficient, cost-effective, and reliable.
Moreover, experts have also warned that the public may find the new definitions confusing. Simple communication is vital, and there are concerns that these changes may not resonate with everyday individuals.
Dr. Robert Kushner, another report co-author, acknowledged that reframing the understanding of obesity will be a gradual process, but he sees this as an essential first step to ignite meaningful discussions on the topic.
