Call to overhaul obesity diagnoses amid fears of over-reliance on BMI

Doctors are proposing a “radical overhaul” of how obesity is diagnosed worldwide amid concerns that a reliance on body mass index may be causing millions of people to be misdiagnosed.

More than 1 billion people are thought to be living with the condition that for decades has been diagnosed by measuring a person’s BMI (their ratio of height to weight) to estimate the amount of excess body fat they have.

However, there are fears BMI on its own is not a “reliable measure” of an individual’s health and may be resulting in both under- and over-diagnosis of obesity, with “negative consequences” for those affected and wider society.

Dozens of the world’s leading experts across a broad range of medical specialisms – including endocrinology, internal medicine, surgery, biology, nutrition and public health – are now calling for a “reframing” of the condition that is causing major harm on every continent and costing countries billions.

Prof Francesco Rubino, the chair of the Lancet commission which produced the report, said the changes would provide an opportunity for health systems globally to adopt a universal, clinically relevant definition of obesity and a more accurate method for its diagnosis.

He said: “The question of whether obesity is a disease is flawed because it presumes an implausible all-or-nothing scenario where obesity is either always a disease or never a disease. Evidence, however, shows a more nuanced reality. Some individuals with obesity can maintain normal organs’ function and overall health, even long term, whereas others display signs and symptoms of severe illness here and now."

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Source: The Guardian, 14 January 2024