Report: Obesity needs redefinition — BMI shouldn’t be used as measure of health

A global report says the current definition of obesity, based on body mass index (BMI), is inadequate for assessing individual health.

Published in The Lancet Diabetes & Endocrinology, the report involved 58 medical experts from various specialties and countries who reviewed evidence and reached a consensus.

Obesity is currently defined as having a BMI over 30, a calculation based on height and weight.

However, the report argues that BMI alone fails to provide sufficient insight into an individual’s health, potentially undermining healthcare and policy decisions.

The authors recommend distinguishing between “clinical obesity,” where chronic illnesses are linked to weight, and “pre-clinical obesity,” for those at risk of future health issues.

“We recommend that BMI should be used only as a surrogate measure of health risk at a population level, for epidemiological studies, or for screening purposes, rather than as an individual measure of health,” the report reads.

“Policy makers and health authorities should ensure adequate and equitable access to available evidence-based treatments for individuals with clinical obesity, as appropriate for people with a chronic and potentially life-threatening illness.

“Public health strategies to reduce the incidence and prevalence of obesity at population levels must be based on current scientific evidence, rather than unproven assumptions that blame individual responsibility for the development of obesity.

“Weight-based bias and stigma are major obstacles in efforts to effectively prevent and treat obesity; health-care professionals and policy makers should receive proper training to address this important issue of obesity.”

The experts said those with “pre-clinical obesity,” instead of drugs and surgery, should be offered weight-loss advice, counselling and monitoring to reduce the chances of health problems developing.

Francesco Rubino, from King’s College London, who chaired the group, said obesity is a spectrum which some people have and function normally with.

“Others can’t walk well or breathe well, or are wheelchair bound with significant health issues. Obesity is a health risk – the difference is it’s also an illness for some,” he said.