NEW DELHI: Body Mass Index (BMI), long used by doctors to assess obesity, may not be a reliable diagnostic tool, according to a global commission convened by The Lancet Diabetes & Endocrinology, a leading medical journal. The commission has recommended supplementing BMI measurements with other assessments, such as waist circumference or direct measurements of body fat, for a more accurate evaluation.
Limitations of BMI as a Diagnostic Tool
“Relying solely on BMI to diagnose obesity is problematic,” said Robert Eckel, professor at the University of Colorado Anschutz Medical Campus and a member of the expert group.
- Fat Distribution: Excess fat stored in and around organs like the liver, heart, or muscles poses a higher health risk than fat stored beneath the skin in areas like the arms or legs.
- Missed Diagnoses: Some individuals with excess body fat do not meet the BMI threshold for obesity, leading to unnoticed health issues.
- BMI Exceptions: Others may have a high BMI but maintain healthy organ function and show no symptoms of illness.
Dr. Anoop Misra, an Indian expert on the commission, noted the particular challenge of abdominal obesity, which is prevalent in India. “BMI criteria often fail to classify these cases as obesity. The new classification system will address this gap,” he explained.
A New Approach to Obesity Classification
For the first time, The Lancet Commission has recommended sub-dividing obesity into two categories:
- Clinical Obesity: Characterized by signs or symptoms of impaired organ function or difficulty performing daily activities. This group may require medical or surgical interventions to prevent complications like heart attack or stroke.
- Preclinical Obesity: Defined by the absence of clinical manifestations. Individuals in this group generally do not need medication or surgery but may require health monitoring and counseling if their risk of progression is low.
Key Recommendations
The commission emphasized that not all individuals with obesity require medical or surgical treatment. Tailoring interventions to individual needs is critical, as untreated obesity can lead to severe complications, including cardiovascular events.
This nuanced approach to diagnosing and treating obesity offers hope for better health outcomes while reducing unnecessary interventions.
