BMI is the wrong way to measure obesity, researchers say here’s what they recommend instead

A group of 58 researchers are calling for a new, better way to measure obesity.

The global team’s recommendations were published in The Lancet Diabetes & Endocrinology on January 14.

Body mass index (BMI) has been the international standard for measuring obesity since the 1980s, according to many sources, although some experts have questioned its validity.

A person’s BMI is calculated by dividing their weight by the square of their height in feet.

“Obesity is a complex problem and has varying importance at the individual level,” lead report author Francesco Rubino, chair of bariatric and metabolic surgery at King’s College London, UK, told Fox News Digital.

Obesity is a “spectrum,” he said, rather than a “single, distinct clinical entity.”

Rubino continued, “It is impossible to say whether obesity is a disease or not, as disease status may not coincide with body size or simply excess body fat.”

The Commission on Clinical Obesity has proposed a “reframing” of obesity that distinguishes between people who have a disease here and now, and those who may be at risk for the disease in the future, Rubino said.

Rather than relying solely on BMI, researchers also recommend measuring body fat, which is the amount of excess body fat.

Adiposity can be determined by measuring a person’s waist circumference or by taking body scans to measure fat mass, according to the researchers.

The expert group recommends the use of two levels of obesity: preclinical and clinical.

With preclinical obesity, the person has excess body fat that has not affected the function of his tissues and organs.

However, a person may have an increased risk of developing clinical obesity, type 2 diabetes, heart disease and some types of cancer, the researchers noted.

Clinical obesity is defined as “a chronic systemic disease characterized by changes in the function of tissues, organs, the whole individual or a combination thereof, due to excess adiposity”.

With clinical obesity, the person can experience “severe end-organ damage, causing life-changing and potentially life-threatening complications,” the researchers wrote.

Possible effects of clinical obesity can include heart attack, stroke and kidney failure.

“Since these obesity categories are completely new, we cannot measure their relative prevalence in the population,” Rubino noted. “Physicians have not yet had the opportunity to make such a diagnosis because many of the organ dysfunctions that characterize clinical obesity have not been routinely assessed until now.”

The researchers call for future studies into these diagnoses.

“We recommend that clinicians fully assess obese people in the clinic and use other measures of body size—waist circumference or others—to understand whether an elevated BMI is due to excess body fat or other reasons, like muscle growth,” Rubino told Fox News Digital.

When excess body fat — meaning obesity — is confirmed, clinicians should evaluate individuals to determine whether obesity may have caused any organ dysfunction, the researcher said.

“People with clinical obesity suffer from a chronic disease and should be treated in the same way as people suffering from any other chronic disease,” Rubino said.

People with preclinical obesity should undergo “evidence-based health counseling, monitoring of their health status over time, and, when applicable, appropriate intervention to reduce the risk of developing clinical obesity,” they wrote. .

Between August 2021 and August 2023, approximately 40% of US adults were obese, according to the Centers for Disease Control and Prevention (CDC). About 9.4% of those adults were severely obese.

“Obsolete Measure”.

Dr. Brett Osborn, a neurosurgeon, longevity expert and fitness competitor based in Florida, agrees that BMI is an “outdated measure” for diagnosing obesity.

“As medicine evolves, it’s clear that obesity should no longer be defined solely by physical appearance or weight — or weight-for-height, as in BMI calculations,” said the doctor, who was not involved in the new research. , for Fox. Digital News.

“Instead, the condition should be understood through the lens of metabolic dysfunction.”

Obesity is not just a disease of excess weight, Osborn said, but a “systemic metabolic disorder that requires nuanced and individualized care.”

The condition is best measured by looking at factors such as inflammation, insulin resistance and glucose tolerance, according to the doctor.

In some cases, using BMI can result in “muscular athletes” being labeled as obese, he noted, and people with “normal” BMIs can sometimes have “harmful” levels of visceral (abdominal) fat.

Osborn noted that in his clinic, he and his team do not use BMI, instead relying on visceral fat scores, skeletal muscle mass and body fat percentage.

Skeletal muscle mass (muscles that attach to bones) is critical for physical strength and metabolic efficiency, Osborn said.

For optimal health, he recommends that men aim for 50% skeletal muscle mass relative to total body weight and women aim for 45% – although other factors, such as age and fitness levels, come into play.

“Remember, your resilience—your ability to fend off disease—lies in your muscles,” Osborn added.

“By integrating body composition metrics, metabolic markers, and personalized assessments, we can more accurately diagnose obesity and tailor interventions to each individual.”