People with more fat can even then be more active and kicking.
A groundbreaking report has declared that the term “obesity” is medically flawed and should be redefined to better reflect patients’ health needs. Published in The Lancet Diabetes & Endocrinology journal, this report, supported by over 50 global medical experts, advocates for splitting the term into two categories: “clinical obesity” and “pre-clinically obese.” The announcement, made 18 hours ago, highlights the limitations of the Body Mass Index (BMI) as a sole diagnostic tool.
The report suggests that “clinical obesity” applies to individuals whose weight causes significant health issues, while “pre-clinically obese” refers to those who may be overweight but remain healthy and active, though at risk of future illnesses. This change aims to ensure better care for over one billion people living with obesity worldwide.
Professor Francesco Rubino of King’s College London, who chaired the expert group, stated, “Obesity is a spectrum. Some individuals can maintain normal organ function despite being obese, while others suffer severe illness. Our current definition is too simplistic and fails to address individual needs.”
BMI Under Fire
BMI, widely used to assess whether an individual is underweight, healthy, or obese, has been criticized for its inability to account for muscle mass, fat distribution, or individual health conditions. Calculated by dividing weight in kilograms by height in meters squared, BMI often misclassifies muscular individuals as obese and overlooks the dangers of fat accumulation around vital organs.
Experts argue that while BMI is useful for population-level assessments, it is inadequate for diagnosing individual health. Instead, they recommend combining BMI with waist measurements, fat distribution analysis, and medical histories to provide a more accurate health assessment.
Real-Life Stories Highlight the Issue
The debate surrounding BMI resonates with individuals like Natalie from Crewe, who regularly exercises and follows a healthy diet but is classified as obese based on her BMI. “I consider myself fit and healthy. My doctor agrees, but my BMI doesn’t reflect that,” Natalie shared.
Others, like Richard from Falmouth, find BMI misleading due to their unique body compositions. Despite being borderline obese according to BMI, Richard’s body fat percentage is only 4.9%, largely due to his high muscle mass.
These stories emphasize the need for a nuanced approach to assessing and managing obesity, experts say.
Defining the Two Groups
The report outlines distinct pathways for managing “clinical obesity” and “pre-clinically obese” individuals.
- Clinical Obesity: This applies to those showing signs of related illnesses such as heart disease, diabetes, or joint pain. Treatment typically involves medications, lifestyle changes, or surgery.
- Pre-Clinical Obesity: For those at risk but not yet ill, preventive measures like counseling, dietary advice, and regular monitoring are recommended.
By focusing on these two categories, healthcare providers can tailor treatments to individual needs, potentially reducing unnecessary interventions while ensuring appropriate care.
Weight-Loss Drugs in Focus
The redefinition is particularly significant as demand for weight-loss medications, such as Wegovy and Mounjaro, rises. These drugs, capable of reducing body weight by up to 20%, are currently restricted to individuals with a BMI over 30 and weight-related health conditions. Experts believe the new classification could make these treatments more accessible to those who truly need them.
Implications for Healthcare Systems
While the report has been praised for its compassionate and science-based approach, concerns remain about its implementation. Critics warn that healthcare systems already stretched thin may struggle to provide adequate resources for patients in the “pre-clinically obese” category, potentially diverting funds from those with more immediate medical needs.
Nonetheless, children’s obesity expert Professor Louise Baur from the University of Sydney supports the redefinition, stating it would lead to better care for both adults and children while reducing overdiagnosis and unnecessary treatments.
The Royal College of Physicians echoed this sentiment, calling the report a strong foundation for treating obesity with the same rigor as other chronic conditions.
A Step Towards Precision Medicine
As obesity continues to affect millions globally, redefining how it is diagnosed and treated is critical. This report paves the way for a more personalized, compassionate, and effective approach, emphasizing that obesity is not just a number on a scale but a complex spectrum of health challenges and risks.
The new classifications aim to shift the focus from stigma and generalization to understanding and tailored care, ensuring patients receive the help they truly need.
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