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Obesity Diagnosis Needs Change, Study Says Fat Distribution More Important Than BMI

Obesity Diagnosis Needs Change, Study Says Fat Distribution More Important Than BMI


The obesity diagnosis should not be limited to just checking the Body Mass Index (BMI). A recent study revealed that assessing distribution of body fat is more crucial than solely relying on BMI.

The researchers of the latest study put forth a new framework for the diagnosis, staging, and management of obesity in adults as they say limiting the diagnosis to a BMI cut-off level of 30 may exclude many people who would benefit from obesity treatment.

As per the new framework launched by the European Association for the Study of Obesity (EASO) and published in Nature Medicine, abdominal fat accumulation or visceral fat is an important risk factor for health deterioration, for even people with low BMI and without any clinical manifestations of obesity.

Including those individuals with lower BMI but higher visceral fat in the definition of obesity, reduces the risk of undertreatment in comparison to the current BMI-based definition, the researchers noted.

“An important novelty of our framework regards the anthropometric component of the diagnosis. The basis for this change is the recognition that BMI alone is insufficient as a diagnostic criterion, and that body fat distribution has a substantial effect on health. More specifically, the accumulation of abdominal fat is associated with an increased risk of developing cardiometabolic complications and is a stronger determinant of disease development than BMI, even in individuals with a BMI level below the standard cut-off values for obesity diagnosis (BMI of 30),” the EASO Steering Group members who have put together the framework wrote.

The researchers recommend those falling into the new definition of obesity also follow currently available guidelines for obesity management which include behavioral modifications such as nutritional therapy, physical activity, stress reduction, and sleep improvement, along with psychological therapy, obesity medications, and metabolic or bariatric procedures.

As per the research recommendations, obesity medications should be considered for patients with a BMI of 25 kg/m² or higher, a waist-to-height ratio above 0.5, and medical, functional, or psychological issues, regardless of BMI cut-off values.

“This statement may also be seen as a call to pharmacological companies and regulatory authorities to use inclusion criteria that are more adherent to the clinical staging of obesity and less to traditional BMI cut-offs when designing future clinical trials with obesity medications. This statement will move obesity management closer to the management of other non-communicable chronic diseases, in which the goal is not represented by short-term intermediate outcomes, but by long-term health benefits,” the researchers noted.



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