(Image source from: Canva.com)
For decades, doctors have used body mass index (BMI) as a tool to measure obesity. BMI is defined as a measure of body fat percentage based on weight in kilograms divided by the square of height in meters. People with a BMI over 30 are usually considered obese. However, doctors say people with excess body fat may not always have a BMI over 30 and health risks may be underestimated. So, in a new study, India's leading experts have redefined obesity among Indians and looked at the unique health challenges Indians face. Experts including doctors, surgeons, physiotherapists and nutritionists from National Diabetes and Cholesterol Foundation (N-DOC), Fortis Hospital C-DOC and All India Institute of Medical Sciences (AIMS) provide guidelines for obesity treatment. The diagnosis 15 years later and a new definition published by The Lancet Diabetes and Endocrinology on January 15th.
Dr. Naval Vikram from AIIMS School of Medicine said: "This study offers Indians a unique and targeted approach to combat obesity and related diseases." Although excess body fat can cause health problems, obesity is often a warning sign of other diseases rather than one Illness. This idea is still being debated. In addition, there are disadvantages to using BMI (body mass index), which has always been the standard measure of obesity. BMI can overestimate or underestimate body fat and does not provide a complete picture of a person's health. The Lancet researchers defined clinical obesity as a disease state that results directly from the effects of excessive fat accumulation on organ and tissue function, similar to the concept of chronic disease in other medical specialties.
Obesity means having too much body fat, which can be harmful to your health. Obesity is defined by body fat, but accurate measurement often requires specialized equipment such as bioelectrical impedance or DEXA scans, which are expensive and usually not available in clinics. Overweight people store different amounts of fat, but where the fat is located in the body is very important. Research has shown that excess fat around the stomach is more dangerous than fat accumulation elsewhere and increases the risk of disease. According to Indian doctors and researchers, several factors require a new definition and guidelines for obesity.
Outdated BMI standards: The old guidelines from 2009 relied solely on BMI (weight-to-height ratio) to diagnose obesity. Recent research shows that BMI alone is not enough, especially for Indians.
Abdominal Obesity: Studies have shown a strong link between abdominal fat, inflammation and primary health problems in Indians.
Clarify risks: New guidelines differentiate between “harmless overweight” and overweight that is harmful to health.
KEY CHANGES IN THE NEW GUIDELINES
Beware of Belly Fat: Belly fat is a key factor in diagnosing obesity as it is linked to insulin resistance and other diseases.
Health problems are important: the definition includes problems related to obesity, such as diabetes, heart disease and joint pain.
Two-step classification:
Stage 1 obesity: increased fat content (BMI > 23 kg/m²), no visible effect on organ function or normal daily activities. This stage of obesity, which does not currently cause pathological problems ("benign obesity"), can progress to stage 2 obesity, which is associated with mechanical and disease-related problems.
Obesity stage 2: late-stage obesity with BMI greater than 23 kg/2, abdominal fat, excess waist circumference (WC) or waist-to-height ratio (W-HtR). One affects the functioning of the body and organs: mechanical diseases (such as obesity-related knee arthritis) or the presence of obesity-related diseases (such as type 2 diabetes).
The above situation shows that obesity affects the functioning of body organs, increases symptoms and requires intensive treatment.
The guidelines were developed using the Delphi process, a method for reaching expert consensus. Five surveys were conducted between October 2022 and June 2023.
Introduced 15 years after the last update, the new definition provides a clear and practical framework for the diagnosis and management of obesity in India. The focus on India's particularities is aimed at curbing the growing epidemic of obesity and related diseases such as diabetes.
