A group of 58 researchers has called for a new, better way to measure obesity.
The global team's recommendations were published on January 14 in The Lancet Diabetes & Endocrinology.
According to many sources, body mass index (BMI) has been the international standard for measuring obesity since the 1980s, although some experts question its validity.
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A person's body mass index is calculated by dividing his or her weight by the square of his or her height in feet.
According to many sources, body mass index (BMI) has been the international standard for measuring obesity since the 1980s, although some experts question its validity. (iStock)
"Obesity is a complex problem that has different implications on an individual level," Francesco Rubino, lead author of the report and director of bariatric and metabolic surgery at King's College London, UK, told Fox News Digital.
Obesity is a "spectrum" rather than a "single, unique clinical entity," he said.
"It's impossible to say whether obesity is a disease because the disease state cannot be consistent with body size or simply excess body fat," Rubino continued.
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Rubino said the Clinical Obesity Committee proposed a "redefinition" of obesity to differentiate between people who currently have the disease and those who may be at risk for the disease in the future.
Researchers recommend not relying solely on body mass index but also measuring fat content, the amount of excess fat in the body.
A person's body mass index is calculated by dividing his or her weight by the square of his or her height in feet. (iStock)
Researchers say obesity can be determined by measuring a person's waist circumference or taking a body scan to measure fat mass.
The expert panel recommends two obesity levels: preclinical and clinical.
With preclinical obesity, patients have excess body fat that does not affect the function of their tissues and organs.
"People with clinical obesity have a chronic disease and should be treated like people with any other chronic disease."
However, the researchers noted that this person may be at increased risk for clinical obesity, type 2 diabetes, heart disease, and certain types of cancer.
Clinical obesity is defined as “a chronic systemic disease characterized by functional changes in tissues, organs, the entire individual, or a combination thereof due to excessive adiposity.”
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People with clinical obesity may experience "severe end-organ damage leading to life-changing and potentially life-threatening complications," the researchers wrote.
Potential effects of clinical obesity may include heart attack, stroke and kidney failure.
"Because these types of obesity are so new, we cannot measure their relative prevalence in the population," Rubino noted. "Physicians have not yet been able to make such a diagnosis because, to date, many of the organ dysfunctions that characterize clinical obesity have not been routinely evaluated."
When excess body fat is confirmed, clinicians should evaluate the individual to determine whether obesity may be contributing to any organ dysfunction, the researchers said. (iStock)
The researchers call for future research into these diagnostics.
"We recommend that clinicians thoroughly evaluate obese patients in the clinic and use other measures of body size - waist circumference or other - to understand whether increased body mass index is due to excess body fat or other causes such as increased muscle mass, " Rubino told Fox News Digital.
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When excess body fat (i.e., obesity) is confirmed, clinicians should evaluate the individual to determine whether obesity may be contributing to any organ dysfunction, the researchers said.
"People with clinical obesity have a chronic disease and should be treated like people with any other chronic disease," Rubino said.
People with preclinical obesity should receive "evidence-based health counseling, have their health status monitored over time, and have appropriate interventions, when applicable, to reduce the risk of developing clinical obesity," they wrote.
According to the Centers for Disease Control and Prevention (CDC), approximately 40% of U.S. adults were obese between August 2021 and August 2023. Approximately 9.4% of adults are severely obese.
Florida neurosurgeon, longevity expert and bodybuilder Dr. Brett Osborne agrees that body mass index is an "outdated measure" for diagnosing obesity.
"It's clear that obesity should no longer be defined solely by appearance or weight."
The doctor, who was not involved in the new study, told Fox Digital News: "As medicine evolves, it's clear that obesity should no longer be defined solely by appearance or weight, or by body mass index, which is the ratio of weight to height. ."
"Instead, the condition must be understood in terms of metabolic dysfunction."
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Obesity is not just a disease of excess weight, Osborne said, but a "systemic metabolic disorder that requires nuanced and personalized care."
Doctors say the condition can be better gauged by looking at factors such as inflammation, insulin resistance and glucose tolerance.
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He noted that using body mass index could in some cases lead to "muscular athletes" being labeled obese, while people with a "normal" body mass index could sometimes have "harmful" levels of visceral (abdominal) fat.
Osborne noted that in his own clinic, he and his team do not use body mass index but instead rely on visceral fat score, skeletal muscle mass and body fat percentage.
One doctor has pointed out that in some cases using body mass index could lead to "muscular athletes" being labeled obese. (iStock)
Osborne says skeletal muscle mass (the muscles that connect bones) is critical to physical strength and metabolic efficiency.
For optimal health, he recommends aiming for 50 percent skeletal muscle mass relative to total body weight for men and 45 percent for women—although other factors such as age and fitness level also come into play.
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"Remember, your resilience—your ability to fight off disease—is in your muscles," Osborne adds.
"By integrating body composition measures, metabolic markers and personalized assessments, we can more accurately diagnose obesity and tailor interventions to each individual."