Daijiworld Media Network
New Delhi, Jan 18: A groundbreaking report from the Lancet diabetes & endocrinology commission is reshaping the way obesity is defined and diagnosed in India. Published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews, the report challenges the traditional use of body mass index (BMI) as the primary tool for diagnosing obesity, highlighting its limitations in accurately assessing the health risks associated with excess weight.
The new framework advocates for viewing obesity as a chronic illness rather than merely excess body weight. It underscores that obesity affects the function of organs and tissues, leading to conditions such as heart disease, stroke, and kidney failure.
Dr Anoop Misra, director of the Fortis CDOC Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology in New Delhi, who contributed to the report, criticized the over-reliance on BMI for obesity assessment. "Obesity should not be reduced to excess weight alone; it impacts the body systemically. BMI often fails to reflect actual body fat, either underestimating or overestimating it," Dr Misra explained.
The commission's updated guidelines introduce a more comprehensive approach to obesity diagnosis. In addition to BMI, factors such as waist circumference, waist-to-height ratio, comorbidities, and the impact of obesity on daily life are now considered critical in the assessment.
The report introduces two stages of obesity:
• Stage 1: Characterized by increased body fat (BMI >23 kg/m²) without significant effects on organ functions or daily activities.
• Stage 2: Involves more pronounced adiposity that impacts physical capabilities and raises the risk of comorbid conditions, including diabetes, heart disease, and hypertension. Stage 2 is marked by a BMI above 23 kg/m², excess waist circumference, or waist-to-height ratio, alongside symptoms affecting daily activities.
This updated framework emphasizes that healthcare providers must tailor treatment based on the stage of obesity. While stage 1 may require lifestyle modifications such as improved diet and physical activity, stage 2 may necessitate more intensive interventions, including medical treatments or surgery.
In terms of diagnosis, the commission recommends moving beyond BMI as a sole indicator and instead using a combination of body fat measurements and other anthropometric data, such as waist-to-hip ratio.
Dr Misra also highlighted the importance of public health policies that address weight-based stigma and ensure equitable access to effective treatments. "Training healthcare professionals and policymakers is key to overcoming biases and improving obesity management," he said.
This new framework marks a significant step forward in India’s approach to managing obesity, aligning with global efforts to improve diagnosis, treatment, and public understanding of the condition.