Health experts are proposing new guidelines to diagnose obesity

The Lancet Diabetes & Endocrinology Commission has recommended new dietary guidelines and criteria for diagnosing and treating obesity. Image (c) ConsumerAffairs

Researchers say that obesity goes beyond just BMI

Obesity has been an ongoing struggle for many consumers, and for years, body mass index (BMI) has been the key metric health professionals have used to determine overweight and obesity

Now, the Lancet Diabetes & Endocrinology Commission, which includes health experts from 75 global organizations, is calling for a new method of defining and diagnosing obesity that goes beyond just BMI. 

The commission has created a new definition of obesity and new guidelines for diagnosing obesity. The goal is for consumers to better understand their overall health risks and receive the proper care they need. 

“The commission’s report is a major step forward in recognizing obesity as a disease and not merely a risk factor. It also helps clinicians identify individuals who are in need of treatment,” Dr. Robert Kushner, a member of the commission, said in a news release. 

What’s new? 

The researchers explained that relying on BMI alone doesn’t give health care professionals a full picture of consumers’ health. Instead, they suggest doing the following: 

  • Getting at least one measurement of body size – waist circumference, waist-to-hip ratio, or waist-to-height ratio – in addition to BMI 

  • Getting at least two measurements of body size – waist circumference, waist-to-hip ratio, or waist-to-height ratio – regardless of BMI 

  • Getting direct body fat measurements – bone densitometry scan or DEXA – regardless of BMI 

“Relying on BMI alone to diagnose obesity is problematic as some people tend to store excess fat at the waist or in and around their organs, such as the liver, the heart or the muscles, and this is associated with a higher health risk compared to when excess fat is stored just beneath the skin in the arms, legs or in other body areas,” Commissioner Professor Robert Eckel said in a news release. 

“But people with excess body fat do not always have a BMI that indicates they are living with obesity, meaning their health problems can go unnoticed. Additionally, some people have a high BMI and high body fat but maintain normal organ and body functions, with no signs or symptoms of ongoing illness.” 

Pre-clinical obesity and clinical obesity

In addition to these new guidelines, the Commission is recommending two new obesity-related diagnostic categories – pre-clinical obesity and clinical obesity. 

In their report, they define clinical obesity as a standalone illness that’s characterized by both reduced organ function or a reduced ability to engage in regular daily activities. On the other hand, pre-clinical obesity is the early stages of the disease when it remains a risk factor, but all other health markers are in normal range. 

“This nuanced approach to obesity will enable evidence-based and personalized approaches to prevention, management, and treatment in adults and children living with obesity, allowing them to receive more appropriate care, proportional to their needs. 

“This will also save health care resources by reducing the rate of overdiagnosis and unnecessary treatment,” said Commissioner Professor Louise Baur.