Experts Call for New Definition of Obesity to Better Reflect Health Status

The report highlights the need for a revised classification of obesity, recommending terms like "clinical obesity" for those with health complications and "pre-clinical obesity" for others, aiming for a more personalized treatment approach while addressing potential healthcare funding concerns.

A recent report from a team of international health experts suggests that obesity needs a reevaluation of its definition, as many individuals with excess body fat may lead active and healthy lives. The report indicates that an improved approach should focus on the overall health status of patients instead of just their body mass index (BMI) measurements.

The experts propose that individuals experiencing obesity-related chronic conditions should be classified as having "clinical obesity," while those without health issues should be labeled as having "pre-clinical obesity." This classification is crucial, as it's estimated that over one billion people globally live with obesity, contributing to the rising demand for prescription weight-loss medications. The report, published in The Lancet Diabetes & Endocrinology journal, has the endorsement of more than 50 medical professionals worldwide.

Professor Francesco Rubino from King's College London, who led the study, emphasized that "obesity is a spectrum" and that while some patients function normally despite their condition, others face significant mobility challenges and health concerns. This delineation aims to "reframe" obesity, providing a clearer distinction between those who have the illness and those who are healthy yet at risk.

Under the current classification system, obesity is typically defined as a BMI exceeding 30, a measurement that estimates body fat based solely on height and weight. In many regions, including parts of the UK, accessibility to weight-loss medications like Wegovy and Mounjaro often hinges on meeting this BMI threshold and having weight-related health complications.

However, the report argues that BMI fails to accurately reflect a patient's overall health status, as it does not distinguish between muscle and fat or account for visceral fat's dangers. The experts advocate for a new model that assesses obesity's impact on bodily organs and overall health through indicators such as heart disease, type 2 diabetes, or joint issues.

For patients diagnosed with "pre-clinical obesity," the suggested approach entails offering counseling and weight-loss guidance rather than immediate medical intervention. "Obesity is a health risk; the difference is it's also an illness for some," Prof Rubino stated, noting the need for accurate risk assessment in the population.

Prof Louise Baur, a children's obesity expert from the University of Sydney, supported the new classification approach, emphasizing that it would ensure appropriate care for individuals dealing with obesity while decreasing the number of unnecessary diagnoses and treatments.

As weight-loss drugs gain increasing popularity, the importance of rethinking obesity classification is apparent, with the report highlighting that improved diagnostic accuracy is more crucial than ever.

The Royal College of Physicians recognized the report's foundation for treating obesity with enhanced medical rigor and compassion. The distinction between clinical and pre-clinical obesity is deemed a vital advancement, encouraging early identification and intervention for affected patients.

Nonetheless, concerns linger regarding health budget constraints that may lead to reduced funding for those classified as pre-obese. Prof Sir Jim Mann, from the Edgar Diabetes and Obesity Research Centre in New Zealand, speculated that limited resources are likely to focus on individuals deemed clinically obese, raising questions about the accessibility of support for broader populations.