
A Lancet Global Commission report recommended a new and nuanced approach to detect obesity. This looks at measures of fat in the body such as waist circumference or waist-to-hip ratio in addition to body mass index (BMI). The report was published in The Lancet Diabetes and Endocrinology journal and endorsed by over 75 medical organisations including the All Indian Association for Advancing Research in Obesity (AIAARO)
The authors of the report said that the current medical approach relies on BMI which is not an accurate measure of health or disease in an individual. This is because it can result in a wrong diagnosis, thereby, negatively impacting people with obesity.
According to the World Health Organisation (WHO), nearly 1 billion of the world's adults aged 18 years and above are living with obesity. WHO defines obesity as an individual who has a BMI that is greater than or equal to 30.
The authors say that part of the problem is the current definition of BMI which says that people of European descent with a BMI that is greater than or equal to 30 are obese. The team says that country-specific cutoffs can help in checking how obesity risk changes with ethnicity.
The authors in the recent report presented a "novel, nuanced approach to diagnose obesity" that could reduce the risk of misclassification. They also introduced two new categories for diagnosing obesity which are "objective measures" of illness in an individual namely 'clinical obesity' and 'pre-clinical obesity'.
While clinical obesity refers to a chronic or persistent condition because of an obesity-related organ dysfunction, pre-clinical obesity is related to an increased health risk without illness.
Francesco Rubino, Commission chair, King's College London said, "The question of whether obesity is a disease is flawed because it presumes an implausible all-or-nothing scenario where obesity is either always a disease or never a disease. Evidence, however, shows a more nuanced reality. Some individuals with obesity can maintain normal organs' function and overall health, even long term, whereas others display signs and symptoms of severe illness here and now."
Rubino added that the reframing of diagnosing obesity allows for personalised care, including timely access to evidence-based treatments for individuals with clinical obesity, as well as risk-reduction management strategies for those with pre-clinical obesity.
Rubino said, "This will facilitate a rational allocation of healthcare resources and a fair and medically meaningful prioritisation of available treatment options."
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