Obesity no longer just depends on BMI! Cross-national study: Only 27% meet new definition of clinical obesity

Medical experts and organizations advocate including body fat and organ health into the diagnostic criteria for obesity.

A multinational study published on the 11th pointed out that if body mass index (BMI) is no longer the only basis for judgment, but body fat and organ health are also included in the diagnosis of obesity, only about 1/4 to 1/3 of those currently considered obese should be considered to be in poor health.

Reuters reported on the 11th that this study, based on recommendations made by medical experts and organizations last year, included body fat and organ health in the diagnosis of obesity. After analyzing the data of nearly 850,000 adults in China, the United Kingdom, the United States and Spain, it was estimated that 1% to 3% of people who were originally diagnosed as obese based only on BMI would not meet the new diagnostic criteria; another 5% to 9% would be diagnosed as obese due to reasons such as high body fat. If expanded to the entire population, the number of people affected could reach tens of millions.

The World Health Organization (WHO) estimates that obesity currently affects more than 1 billion people worldwide; obesity may be a risk factor for type 2 diabetes, cardiovascular, liver and kidney disease, and cancer.

The new obesity diagnosis framework recommends that in addition to BMI, body fat indicators such as waist circumference should also be measured, and whether there are abnormal functions of the heart, liver and other organs related to weight should be considered. This means that a high BMI alone may no longer be considered obesity; those with a high BMI and high body fat will be diagnosed as "pre-clinical obesity", and those with abnormal organ function will be diagnosed as "clinical obesity". This situation is considered to have formed a disease and usually requires more urgent treatment.

This study attempts to present what the new definition means for the diagnosis, prevalence, and treatment of obesity. According to these new standards, an average of about 27% of obese people in these four countries are clinically obese, accounting for about 8.5% of all adults in these countries; as for preclinical obese people, an average of about 82% have not progressed to clinical obesity, but China and Spain have a higher proportion of progress.

Francesco Rubino, professor of metabolism and bariatric surgery at King's College London, who published this study in the journal Nature on the 11th, said that it is widely known that BMI measurement is not accurate enough, "but we still don't have a better system." The purpose of the new structure is to provide "clinically meaningful descriptions of obesity" that can be used as a basis for medical care and policy.