Classing people as obese is medically ‘flawed’ and the definition should be split in two, according to a study by global experts reported by the BBC.
Published in The Lancet Diabetes & Endocrinology journal, the report had the support of more than 50 medical experts around the world, the 15 January report said.
Although the term “clinical obesity” should be used for patients with a medical condition caused by their weight, the term “pre-clinically obese” should be applied to those remaining fat but fit, although at risk of disease, the report said.
This is a better approach for patients rather than relying exclusively on body mass index (BMI) – a measurement that estimates body fat based on height and weight, according to the study.
In many countries, obesity is defined as having a BMI of over 30. However, BMI has limitations as it fails to distinguish between muscle and body fat or measure the more dangerous fat around the waist and organs.
More than a billion people are estimated to be living with obesity worldwide and prescription weight-loss drugs are in high demand, according to the BBC report.
Prof Francesco Rubino from King’s College London, who chaired the expert group, said obesity was a “spectrum”.
“Some individuals with obesity can maintain normal organ function and overall health, even long term, whereas others display signs and symptoms of severe illness,” Rubino was quoted as saying.
The current definition means too many people are being diagnosed as obese but not receiving the most appropriate care, according to the report.
The report said BMI was useful on a large scale, to work out the proportion of a population who were a healthy weight, overweight or obese.
However, it revealed nothing about an individual patient’s overall health or if they had heart problems or other illnesses.
Measuring a patient’s waist or the amount of fat in their body, along with a detailed medical history, can give a much clearer picture than BMI, according to the report.
While the Royal College of Physicians said the report laid a strong foundation “for treating obesity with the same medical rigour and compassion as other chronic illnesses”, others had raised concerns pressure on health budgets could mean less money for patients in the “pre-obesity” category.
