Redefining obesity may end the diagnosis debate, but health problems remain

Obesity is one of the world’s biggest health challenges, leading to a multitude of shorter and unhappier lives and an increasing burden on already overburdened healthcare systems.

There’s no doubt that more people than ever before are living with excess body fat, and there’s no doubt about the dangers this poses. Obesity has the ability to damage every single organ in the body and increases the risk of type 2 diabetes, heart disease, cancer and mental illness.

But at the same time, the idea of ​​obesity as a disease itself has been at the center of one of the most controversial and polarizing debates in modern medicine. The row is rooted in the fact that although some people may tick the box as obese, currently identified as having a body mass index (BMI) above 30, they show no signs or symptoms of ill health and that their organs work perfectly. order.

Other people who are not currently classified as obese – because their BMI is less than 30 – may actually have serious, undiagnosed health problems as a direct result of excess body fat around their bodies.

A new one reportwritten by dozens of the world’s leading experts and published in the journal The Lancet Diabetes & Endocrinology, aims to finally settle the dispute. They argue that a ‘reframing’ around obesity is needed to prevent millions of people from being misdiagnosed, and to ensure that only those who need treatment are offered it.

First, they propose a more accurate way to diagnose obesity. Instead of relying solely on BMI, they say other measures should also be used, such as waist circumference, waist-to-hip ratio or waist-to-height ratio – an important change, because people tend to have excess body fat on can store different parts of the body. the body.

Some keep it around their waist or around their organs, such as the liver or heart. This is associated with a higher health risk compared to when excess fat is stored just under the skin in the arms, legs or other parts of the body.

Healthcare workers should now also look for signs and symptoms of ill health in the patient caused by excess body fat, the experts said.

Secondly, it proposes how the condition is classified, with two new categories: clinical obesity and preclinical obesity.

The changes are intended to help reduce stigma and improve patient management. Those diagnosed with clinical obesity could be given weight-loss drugs, while those with preclinical obesity could be given advice to become healthier and avoid gaining weight.

While the proposals may help end the debate over diagnosis, the bigger challenge – reducing obesity – remains. Measures such as eating healthier and slower, becoming more active, sleeping better, managing stress and limiting screen time can help people reduce their risk of developing obesity.

But it would be unwise to think that people can rely on education and willpower alone. Governments, companies and communities also need to do much more to help people overcome or prevent obesity.

That includes promoting active travel so people rely less on cars, cracking down on junk food advertising and tackling destructive food environments steeped in unhealthy food choices.