NEW DELHI: For years, doctors have relied on Body Mass Index (BMI) calculations to assess obesity. However, a global commission convened by The Lancet Diabetes & Endocrinology, a reputed medical journal, now argues that BMI provides inaccurate results.
It has suggested doctors should confirm whether a person has obesity or not by at least one other body measurement, for example, waist circumference, or by measuring body fat directly.
BMI is a medical screening tool that measures the ratio of a person’s height to her or his weight to estimate the amount of body fat she or he has.
Current definition says a person with a BMI of 30 kg/m2 and above can be considered obese.
According to the Lancet Commission’s report, which was released Tuesday, people with excess body fat do not always have a BMI above 30, meaning that their health risk can go unnoticed.
Similarly, it says, individuals with high muscle mass (eg. Athletes) tend to have high BMIs despite normal fat mass and diagnosing them as having obesity or a disease was inappropriate.
“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. 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.” Robert Eckel, a professor at the University of Colorado Anschutz Medical Campus (USA), who was part of the expert group, said.
Dr Anoop Misra, a doctor from India who was in the expert committee, added: “Abdominal obesity is very common in India. The existing criteria based on BMI measurement often fails to classify them as obesity. The new classification will help remove this hurdle.”
The Lancet Commission says not all persons having obesity need medical or surgical intervention. It has, for the first time, recommended sub-dividing obesity into two groups: clinical obesity and pre-clinical obesity, based on the presence or absence, respectively, of objective clinical manifestations (ie, signs and symptoms) of altered organ function or impairment of an individual’s ability to conduct daily activities.
Persons with preclinical obesity, the Commission suggests, does not generally require treatment with drugs or surgery, and might need only monitoring of health over time and health counselling if the individual’s risk of progression to clinical obesity or other diseases is deemed sufficiently low.
However, it adds, those having clinical obesity may require medical or surgical intervention as obesity, if left untreated, can lead to serious complications including an increased risk of heart attack and stroke.
