A group of researchers have called for doctors to stop using the Body Mass Index (BMI) to define obesity.
The announcement follows three years of research by “56 leading experts” from a range of different countries.
In a paper published in the, researchers said “other measurements of body size” should be used due to the “limitations of BMI”.
Instead, they suggest using two categories of obesity to determine what treatment doctors should prescribe.
BMI
BMI categorises people based on height and weight and has been used by doctors to diagnose obesity. It was developed in the 1830s by a mathematician as a way to find the ‘average’ male body.
In recent years, some doctors have advised against using it as a standalone tool to measure.
National eating disorder charity the Butterfly Foundation has called BMI an “outdated” and oversimplified measure, which “does not acknowledge the differences between muscle mass and fat distribution [or] consider age, sex, bone structure… or ethnicities”.
About the study
In 2022, a group of researchers established a ‘Commission’ to “propose a definition for clinical obesity,” replacing the BMI system.
This definition could then be used when doctors believed a person’s weight was threatening their health.
The researchers noted flaws with BMI, under which a person defined as obese might not “present evidence of diseased organs or experience limitations in daily activities”.
“Indeed, obesity-related diseases can also develop in the absence of obesity.”
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The Commission has now proposed a new, two-stage definition: pre-clinical and clinical obesity.
Pre-clinical obesity is considered a “risk factor” for diseases, while clinical obesity is a “stand-alone illness” caused by “the effect of [body fat] on the function of organs and tissues.”
Doctors are encouraged to use measurements other thanto figure out if people fit either definition.
These could include waist circumference, a body fat measurement, or a person’s waist-to- height ratio.
Changes
acknowledged the convenience of using BMI, but said “continuing with the current inaccurate diagnostic framework” would have negative impacts.
Early data analysis found “a substantial number” of those defined as obese don’t meet the researchers’ criteria for clinical obesity. This limits their access to care and the diagnosis of other health issues.
The Commission said the current data on obesity needs to be updated to “reflect obesity as a spectrum of medical presentations.”
Comments
Dietitians Australia welcomed the, saying: “People deserve access to the healthcare they need when they need it — regardless of their body size.”
President Dr Fiona Willer said: “We know poeple living in larger bodies going to see their healthcare professionals with a healthconcern are at risk of having their concern ignored or incorrectly attributed to their body weight.”
“We welcome the approach to be more modern — including adding a suite of options beyond BMI”.
