This could represent a significant advance in the treatment of obesity globally. An international commission published a report on January 14, 2025 in the journal The Lancet Diabetes & Endocrinology, proposing to clarify the definition of obesity.
Until now, doctors mainly focused on patients’ body mass index (BMI), and therefore their weight. However, the report highlights the need to also consider the amount of body fat and associated medical complications.
This new definition should make it possible to establish a more accurate diagnosis “shade” et “more precise”underlines the report published in the journal The Lancetand relayed by the BBC and the New York Times. This could result in many people being wrongly diagnosed as obese.
The commission proposed, rather than using BMI as the sole indicator of obesity, that this index be used primarily to determine who might be likely to take a screening test for excess body fat. In this sense, people with a BMI greater than 25 but in good health should not be included among individuals defined as obese. Instead, they should be considered “pre-clinical obesity” and doctors should simply advise them not to gain more weight, or even to lose it.
If the BMI is recognized for its relevance for understanding health problems such as diabetes, heart disease or even cancer, the use of this measurement is often abusive.
Defining obesity differently
According to doctors, the easiest way to know if a person is obese is to measure their waist size using a tape. For a man, if the waist circumference exceeds 101 centimeters, the person should be considered obese. For a woman, the threshold is set at 87 centimeters. In both cases, these individuals likely have too much body fat.
Of course, there are other ways for health professionals to measure obesity: the waist-hip ratio and DEXA scans (an x-ray to analyze our body composition) are among them.
The fifty-eight specialists gathered within the commission worked hard to propose a new definition of obesity. They wanted to approach it from another angle than just the disease. “We have struggled to precisely define what problem weight is.”says Mariell Jessup, scientific and medical director of the commission. “How to define an ideal weight and a worrying weight?”relate-t-elle.
Furthermore, defining obesity as a chronic disease or not presents things in a binary way. “We could not be satisfied with answering this question with yes or no. We think it’s more complex,” continues Mariell Jessup.
The application of the new standards could have implications on the prescription, or not, of drugs against obesity. These treatments, the price of which is considerable, are no longer covered by all insurance. But some people, who benefited from these drugs, were defined as obese solely based on their BMI. From now on, treatment should only be prescribed to people with clinical obesity, whose “needs are compelling”, recommends commission member Dr. David Cummings.
Source: www.slate.fr
