For decades, BMI has been the threshold in identifying obesity. Yet, the report gives a conflicting stance, arguing that BMI alone is an insufficient and often misleading measure of health. The research underscores that BMI does not account for factors such as waist circumference, ethnicity-specific risks, or the presence of weight-related health complications. 

“The goal is to achieve a more precise definition, targeting individuals who need help the most.”, said Dr David Cummings, one of the researchers. The current BMI thresholds, which label individuals with results over 30 as obese, are particularly problematic when applied universally across populations. The report emphasizes the need for country-specific BMI cut-offs while keeping in mind the ethnic and regional differences in obesity-related health risks.

The report by Lancet introduces two new categories for defining obesity; clinical obesity and pre-clinical obesity. The classifications aim to provide a clearer understanding of the condition:

Clinical Obesity

This diagnosis involves evidence of obesity-related organ dysfunction, such as heart disease, liver or kidney problems, or high blood pressure. It combines BMI data with other health markers to confirm the presence of disease caused by excess weight. 

Pre-Clinical Obesity 

This category identifies individuals at increased risk of developing obesity-related conditions without any current signs of illness. It emphasizes early intervention to prevent long-term health consequences.

The idea behind introducing these categories is to reduce the risk of misclassification and help healthcare providers deliver more effective and targeted treatments. 

The report has received support from over seventy five medical organizations worldwide, including the All-Indian Association for Advancing Research in Obesity (AIAARO). It advocates for the importance of redefining obesity not just as a disease but as a condition that can manifest across a spectrum of health states.

“Evidence shows a nuanced reality. Some individuals with obesity maintain normal organ function and overall health, while others experience severe illness.”, said Francesco Rubino, Commission Chair at King’s College London while explaining how this distinction challenges the traditional view of obesity as a disease.

With over one billion people living with obesity worldwide, according to the World Health Organization (WHO), the proposed diagnostic overhaul has significant implications. By having a better understanding of BMI and its perceived connection with obesity, healthcare systems can better address the needs of individuals suffering from or at risk of obesity-related conditions.

The recent report of Lancet advocates for a more inclusive and evidence-based approach to obesity care while prioritising compassion and precision. This shift marks a critical step toward combating one of the most pressing public health challenges of our time.