New guidance from a group of global health experts suggests expanding the definition of obesity beyond the well-known measure of body mass index (BMI).
The new guidance comes from the Clinical Obesity Committee, which is led by dozens of medical experts from various medical specialties around the world. The committee recommends including measurements of body fat and the presence of existing health problems, and cautions against using BMI alone as an individual measure of health.
The proposal recommends using the terms “preclinical” and “clinical” obesity to provide more nuanced approaches to the assessment and management of obesity.
Pre-clinical obesity refers to excess fat without organ dysfunction, but an increased risk of developing clinical obesity and other long-term health problems, such as cardiovascular disease and type 2 diabetes.
“That is, their organs are functioning well. They don’t have metabolic disease, and they have a pretty good quality of life,” said Dr. Robert Kushner, dean and professor of medicine and education at Northwestern University’s Feinberg School of Medicine, in an interview with ABC news.
Clinical obesity, on the other hand, is excess fat that directly affects organ function or limits the individual’s ability to perform daily activities. It can cause life-threatening complications such as heart attack, kidney failure and/or stroke.
“Extra body fat affects people’s health or quality of life,” Kushner said.
The report outlines the diagnostic criteria for obesity by combining a high BMI with at least one abnormal body fat measurement, such as waist circumference, waist-to-hip ratio, waist-to-height ratio, or an elevated direct body fat measurement. scan
Notably, two or more abnormal body fat measurements can classify an individual as obese, regardless of BMI.
Obesity is currently defined as a BMI of 30 or more in adults World Health OrganizationIt affects 1 in 8 adults. However, using BMI alone to aid in the diagnosis of obesity has its limitations.
“BMI doesn’t take into account body composition, or how much body weight is fat or the location of fat,” Dr. Louis Aronne, director of the Center for Comprehensive Weight Control at Weill Cornell Medicine, told ABC in an email. News “As a result, someone can have a normal weight but have a high percentage of body fat and be at risk of clinical obesity. Also, someone can have a high BMI but have a relatively low percentage of body fat.”
The committee also emphasized that obesity is a chronic disease with significant health consequences.
“This is a physical phenomenon, not mental or behavioral. Obesity as a disease-causing entity causes or exacerbates a wide range of diseases. Losing weight makes everyone better at the same time,” said Aronne.
“Recognizing that some people have (clinical) complications of obesity and targeting more intensive and expensive treatment makes sense as a cost-effective approach. Those who haven’t reached that (pre-clinical) point can start with less intensive and more expensive treatment,” added Aronne.
It is not clear if or when the medical community will adopt these recommendations.
“We’re trying to get this out,” Kushner said. “We’re putting a stake in the ground to begin with, moving away from the blanket diagnosis of obesity for someone with a high BMI. We really need to start identifying people who are affected by their weight.”
ABC News’ Dr. Brent Gawey contributed to this report.
Dr. Jennifer Miao is a cardiologist and critical care fellow at Yale School of Medicine/YNHH. He is a member of the ABC medical news unit.
