According to recent data, obesity rates in the US have seen a decline for the first time in a decade, potentially aided by the use of weight loss medications. Pre-clinical obesity, characterized by excess fat without organ dysfunction, poses an increased risk for developing clinical obesity and associated health issues like cardiovascular disease and Type 2 diabetes.
Dr. Robert Kushner, a commissioner and professor at Northwestern University’s Feinberg School of Medicine, explained that individuals with pre-clinical obesity generally have well-functioning organs, no metabolic diseases, and a decent quality of life. On the other hand, clinical obesity involves excess fat that impacts organ function or restricts daily activities, potentially leading to severe complications such as heart attack, kidney failure, or stroke.
The diagnostic criteria for obesity as outlined in the report combine elevated BMI with abnormal body fat measurements like waist circumference, waist-to-hip ratio, waist-to-height ratio, or high direct body fat measurements from scans. Notably, having two or more abnormal body fat measurements may classify an individual as obese, irrespective of their BMI.
While the World Health Organization defines obesity as a BMI of 30 or higher in adults, it is acknowledged that using BMI alone for diagnosis has limitations. Dr. Louis Aronne from Weill Cornell Medicine emphasized that BMI does not consider body composition or fat distribution, underscoring the potential for individuals with normal weight but high body fat percentage to be at risk of clinical obesity, and vice versa.
The commission highlighted obesity as a chronic disease with significant health implications, emphasizing the importance of tailored treatment approaches based on pre-clinical or clinical obesity status. Dr. Aronne stressed the need for a more targeted and cost-effective strategy in managing obesity-related complications.
Efforts are underway to promote a nuanced understanding of obesity within the medical community, moving beyond a blanket diagnosis based solely on BMI. The proposed redefinition of obesity to include body fat and health status alongside BMI aims to improve the identification and treatment of individuals adversely affected by their weight.
This report incorporated contributions from Dr. Brent Gawey of ABC News and featured insights from Dr. Jennifer Miao, a board-certified cardiologist and critical care fellow at Yale School of Medicine/YNHH, affiliated with the ABC medical news unit.
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