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New Obesity Definition Challenges Current Use of B.M.I.An international commission made the case for focusing on body fat quantity and the illnesses people experience.
The commission suggested measuring the waist to determine if a person has excess body fat — more than 34.6 inches for a woman indicates too much fat as does more than 40 inches for a man. But other experts say such measurement are often done incorrectly.Credit...iStock/Getty Images PlusJan. 14, 2025
Obesity should be assessed in a way that goes beyond the standard measure of body mass index, or B.M.I., according to a new definition of the condition released by an international commission.
Its report, published Tuesday in The Lancet Diabetes & Endocrinology journal, makes the case for focusing on how much body fat and what medical complications the person has, not just their weight.
If the guidelines are widely adopted, they could change doctors’ perceptions of who needs to be treated for obesity. They could also affect the use of prescription drugs that treat obesity, like Wegovy and Zepbound. The new definition of obesity was endorsed by 76 organizations around the world.
The commission proposed that instead of continuing the current use of B.M.I. — as a way to define obesity — it should be a screening tool to determine who should be tested for excess body fat.
The commission said that people who had a B.M.I. over 25 and too much fat, but who are otherwise healthy, should pretty much be left alone. They should be monitored and counseled not to gain any more weight and possibly to lose some.
Their condition would be called pre-clinical obesity.
Other people with any of the 18 medical conditions caused by obesity — 13 for children and adolescents — require medical treatment to improve their health and prevent serious injuries to organs. The conditions include breathlessness, heart failure, hip or knee pain, metabolic abnormalities and poorly functioning organs.
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