Doctors are proposing a “radical overhaul” of how obesity is diagnosed around the world, amid concerns that reliance on BMI is causing millions of people to be misdiagnosed.
More than one billion people are thought to be living with the condition, which is used to measure a person's BMI (height-to-weight ratio) to estimate the amount of excess body fat. It has been diagnosed for decades by
However, there are concerns that BMI itself is not a “reliable measure'' to measure an individual's health status, and that it may lead to underdiagnosis or overdiagnosis of obesity, leading to “negative effects'' on affected people and society as a whole. .
Dozens of the world's leading experts across a wide range of medical specialties, including endocrinology, internal medicine, surgery, biology, nutrition, and public health, are currently causing significant harm and significant costs on every continent. They are calling for a “reconstitution'' of this disease. A country of billions.
Relying solely on BMI is “ineffective”, according to the report. This is because BMI is not a direct measure of fat, cannot reflect the distribution of fat throughout the body, and does not provide information about a person's health. announced by experts Published in Lancet Diabetes Endocrinology Journal.
The reform proposal, supported by more than 75 medical organizations around the world, diagnoses obesity based on BMI and other measures of excess body fat, such as waist-to-hip ratio and waist-to-waist ratio. We are proposing a new way to do this. Height ratio, objective signs and symptoms of abnormal health status.
Currently, some people with excess body fat do not have a BMI that indicates they are obese. This means potentially serious health problems go unnoticed and untreated. At the same time, people with a high BMI may be diagnosed as obese even though their organs and body functions are maintained normally and there are no signs or symptoms of an ongoing disease.
Professor Francesco Rubino, chair of the Lancet commission that produced the report, said this change is an opportunity for health systems around the world to adopt a universal and clinically relevant definition of obesity and more accurate diagnostic methods. He said he would provide.
“The question of whether obesity is a disease is flawed because it assumes an unlikely all-or-nothing scenario in which obesity is either always a disease or never a disease,” he said. ”But the evidence points to a more nuanced reality. Some obese people are able to maintain normal organ function and overall health even over long periods of time, whereas others may show signs and symptoms of serious illness in the here and now. .
“Considering obesity only as a risk factor, never a disease, can unfairly deny access to time-limited care to people whose health is in poor health due solely to obesity. Defining obesity comprehensively as a disease can lead to overdiagnosis and inappropriate medication and surgical procedures, which can harm individuals and result in enormous costs to society.”
Experts recommended two new obesity categories: clinical obesity and preclinical obesity.
Clinical obesity is defined as objective signs and/or symptoms of reduced organ function or a significant reduction in the ability to perform standard daily activities such as bathing, dressing, and eating, as a direct result of excess body fat. defined as associated obesity. Experts said clinically obese patients are considered to have an ongoing chronic disease and should receive appropriate management and treatment, including weight-loss drugs.
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Preclinical obesity would be defined as obesity with normal organ function. Therefore, people living with preclinical obesity do not have ongoing disease, but may develop clinical obesity or other diseases in the future (such as type 2 diabetes, cardiovascular disease, certain types of cancer, The risk of developing a mental illness (e.g., mental illness) is variable but generally increasing. Experts said people in this category should be supported to reduce their potential risk of illness.
“Our reconfiguration recognizes the nuanced realities of obesity and allows for personalized care,” said Rubino, head of the Department of Metabolic and Bariatric Surgery at King's College London.
The Royal College of Physicians welcomed the report. Dr Cath McCullough, Special Adviser on Obesity, said: 'For too long we have relied on BMI as a simple measure of obesity, but it often misrepresents obesity status and indicates that excess body fat It doesn't fully reflect how it affects people's health.
“The committee's distinction between preclinical and clinical obesity represents an important step forward and reinforces the need for early identification and intervention, while providing appropriate care to those already experiencing severe health effects. is emphasized.”
But Kathryn Jenner, director of the Obesity Health Alliance, said the priority should be to support people living with excess weight, “rather than just focusing on how they weigh themselves”. He said that.
