A person makes use of measuring tape on his waist in California on Jan. 9, 2025. Credit score: AP Picture/JoNel Aleccia
A bunch of world specialists is proposing a brand new method to outline and diagnose weight problems, decreasing the emphasis on the controversial physique mass index and hoping to raised establish individuals who want therapy for the illness brought on by extra physique fats.
Underneath suggestions launched Tuesday night time, weight problems would now not be outlined solely by BMI, a calculation of peak and weight, however mixed with different measurements, similar to waist circumference, plus proof of well being issues tied to additional kilos.
Weight problems is estimated to have an effect on greater than 1 billion individuals worldwide. Within the U.S., about 40% of adults have weight problems, in line with the U.S. Facilities for Illness Management and Prevention.
“The whole goal of this is to get a more precise definition so that we are targeting the people who actually need the help most,” mentioned Dr. David Cummings, an weight problems professional on the College of Washington and one of many 58 authors of the report printed in The Lancet Diabetes & Endocrinology journal.
The report introduces two new diagnostic classes: scientific weight problems and pre-clinical weight problems.
Folks with scientific weight problems meet BMI and different markers of weight problems and have proof of organ, tissue or different issues brought on by extra weight. That would embody coronary heart illness, hypertension, liver or kidney illness or continual extreme knee or hip ache. These individuals can be eligible for therapies, together with food regimen and train interventions and weight problems medicines.
Folks with pre-clinical weight problems are in danger for these situations, however don’t have any ongoing sickness, the report says.
BMI has lengthy been thought-about a flawed measure that may over-diagnose or underdiagnose weight problems, which is at present outlined as a BMI of 30 or extra. However individuals with extra physique fats don’t all the time have a BMI above 30, the report notes. And folks with excessive muscle mass—soccer gamers or different athletes—could have a excessive BMI regardless of regular fats mass.
Underneath the brand new standards, about 20% of people that was categorized as overweight would now not meet the definition, preliminary evaluation suggests. And about 20% of individuals with severe well being results however decrease BMI would now be thought-about clinically overweight, specialists mentioned.
“It wouldn’t dramatically change the percentage of people being defined as having obesity, but it would better diagnose the people who really have clinically significant excess fat,” Cummings mentioned.
The brand new definitions have been endorsed by greater than 75 medical organizations all over the world, however it’s not clear how broadly or shortly they may very well be adopted in apply. The report acknowledges that implementation of the suggestions “will carry significant costs and workforce implications.”
A spokesman for the medical insurance commerce group AHIP, previously referred to as America’s Well being Insurance coverage Plans, mentioned “it’s too early at this point to gauge how plans will incorporate these criteria into coverage or other policies.”
There are sensible points to contemplate, mentioned Dr. Katherine Saunders, an weight problems professional at Weill Cornell Drugs and co-founder of the weight problems therapy firm FlyteHealth. Measuring waist circumference sounds easy, however protocols differ, many docs aren’t educated precisely and normal medical tape measures aren’t sufficiently big for many individuals with weight problems.
As well as, figuring out the distinction between scientific and pre-clinical weight problems would require a complete well being evaluation and lab checks, she famous.
“For a new classification system to be widely adopted, it would also need to be extremely quick, inexpensive, and reliable,” she mentioned.
The brand new definitions are more likely to be complicated, mentioned Kate Bauer, a vitamin professional on the College of Michigan Faculty of Public Well being.
“The public likes and needs simple messages. I don’t think this differentiation is going to change anything,” she mentioned.
Overhauling the definition of weight problems will take time, acknowledged Dr. Robert Kushner, an weight problems professional on the Northwestern Feinberg Faculty of Drugs and a co-author of the report.
“This is the first step in the process,” he mentioned. “I think it’s going to begin the conversation.”
Extra info:
Definition and diagnostic standards of scientific weight problems, The Lancet Diabetes & Endocrinology (2025). DOI: 10.1016/S2213-8587(24)00316-4
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