Obesity should be split into two groups, says global report

Calling people obese is a medical “misnomer” – and the definition should be split into two, report from experts around the world he says.

The term “clinically obese” should be used for patients who have a medical problem due to their weight, while “obese” should be used for those who remain fat but fit despite being at risk of disease.

And this is better for patients than relying on body mass index (BMI) alone – which measures whether they are healthy for their age – to determine obesity.

More than a billion people say they do obesity worldwide and prescription weight loss medications are in high demand.

The report, published in the Lancet Diabetes & Endocrinology journal, is supported by more than 50 medical experts from around the world.

“Some people with obesity can maintain good health, even for a long time, while others show signs of obesity here and there,” said Prof Francesco Rubino, from King’s College London, who chaired the expert group.

“Being overweight is a form,” he added.

The current, blanket definition means that more people are being diagnosed with obesity but not receiving appropriate care, the report says.

Currently, in most countries, obesity is defined as obesity BMI over 30 – a measure that measures body fat based on height and weight.

It is calculated by dividing an adult’s weight in kilograms by their height in square meters.

For example, if he is 70kg (about 11 stone) and 1.70m (about 5ft 7in):

• square length in meters: 1.70 x 1.70 = 2.89
• divide their weight in kilograms by the sum: 70 ÷ 2.89 = 24.22
• round the result to one decimal place: 24.2

Find out what your body mass index (BMI) means on the NHS website

But BMI has limitations.

It feels like someone is gaining weight – but not too much fat.

So people who are very active, like runners, tend to have a high BMI but not be overweight.

The report notes that BMI is useful on a large scale, calculating how many people are healthy, overweight or obese.

But it does not reveal anything about the health of any patient, whether they have heart problems or other diseases, for example, and they fail to distinguish between different types of body fat or measure the most dangerous fat in the waist and organs.

Measuring a patient’s waist or body fat, along with a past medical history, can provide a clearer picture than BMI, the report says.

“Obesity is a health risk – the difference is a disease for others,” said Prof Rubino.

Obesity

When obesity is a disease, there will be symptoms that affect the body parts – through heart disease, shortness of breath, type 2 diabetes or bone pain – and the daily activities of a person. Treatment with drugs or surgery is possible.

Pre-hospital obesity

When obesity poses a health risk – but does not cause disease, people should be given weight loss advice, counseling and screening, to reduce the risk of health problems.

Doctors should also look closely at a patient’s family history to see if they are at risk for certain diseases.

At a time when drugs that reduce body weight by up to 20% are being ordered on a large scale, the report says that redefining obesity is “very appropriate” because it “improves the accuracy of diagnosis”.

Access to weight loss drugs such as Wegovy and Mounjaro is usually only given to patients with a BMI over 30 and weight-related diseases.

Childhood obesity expert Prof Louise Baur, from the University of Sydney, who co-authored the report, said the new approach would allow adults and children with obesity to “receive the right care”, and reduce the number of cases diagnosed. and given unnecessary support. .

The Royal College of Physicians said the report laid a strong foundation “for treating obesity as boldly and compassionately as other chronic diseases”.

But others worry that pressure on health budgets could mean less money for patients in the “pre-obesity” category.