Experts are advocating for a reassessment of obesity definitions to potentially benefit millions globally, proposing a new classification of “preclinical” obesity.
The World Health Organization (WHO) currently defines obesity as excess body fat that poses health risks, primarily assessed through body mass index (BMI). A BMI of 18.5 to 24.9 is deemed healthy, while below or above indicates underweight or overweight status, respectively. A BMI of over 30 is classified as obese.
Excess body fat can infiltrate organs like the liver and pancreas, impairing their functions and increasing the likelihood of serious health issues, including cancer and heart disease. However, BMI does not accurately reflect an individual’s body fat. “With BMI, we can’t discern whether that ‘excess’ weight comes from body fat, muscle mass, or bone density,” explains a leading researcher in obesity studies.
Traditional methods for assessing body fat, such as waist measurements or X-ray scans, fail to fully determine individual health outcomes. “Responses to excess body fat vary significantly among individuals, influenced by factors such as race, age, diet, and genetics,” a health expert notes.
The proposed approach aims to introduce more clarity by categorizing obesity into preclinical and clinical stages. Both categories would involve excess body fat; however, only the clinical stage would present symptoms, like difficulty breathing or other health complications. In contrast, preclinical obesity indicates a heightened risk of developing these symptoms over time.
This approach draws parallels to prediabetes, where blood sugar levels are elevated but not high enough for a diabetes diagnosis. Under this new framework, healthcare professionals would measure body fat through waist size or imaging techniques alongside calculating BMI. While individuals with a BMI above 40 would still be presumed to have excess fat, assessments would also include blood tests to evaluate organ health and symptom tracking.
If adopted widely, these revised definitions could lead to personalized healthcare strategies. Those categorized under preclinical obesity might benefit from health monitoring and lifestyle modifications, while individuals diagnosed with clinical obesity could require medical interventions, including medication or surgery.
These updates have garnered support from 76 health organizations globally, with experts noting that more nuanced definitions may challenge the stigma around obesity. “Recognizing obesity as a complex disease influenced by various factors, rather than merely a behavioral issue, is crucial in enhancing understanding and treatment,” concludes a health researcher advocating for these changes.
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