Proposed changes to the Body Mass Index (BMI) measurements could potentially classify countless more people as obese, in a bid to extend the scope of obesity treatments.
A group of scholars from the European Association for the Study of Obesity is pushing for an overhaul of the traditional BMI system. The suggested amendment may result in numerous individuals currently deemed "healthy weight" being rebranded as "obese", to combat the rising tide of the so-called "skinny fat" issue.
The experts underscored that the alterations to the current NHS-utilised system would enable more people to access obesity treatments that they may significantly benefit from but are currently sidestepped. Specifically, their attention is drawn toward tackling visceral fat that encompasses crucial organs.
Visceral fat is deemed more harmful to overall health and well-being than subcutaneous fat, which is typically more apparent as it resides beneath the skin layer. High levels of visceral fat have been associated with an increased risk of heart disease, diabetes, stroke, dementia, and certain types of cancer.
Currently, individuals can carry high amounts of visceral fat even if they fall significantly under the obesity threshold according to the BMI system. The present BMI methodology involves dividing an individual's weight by the square of their height.
The proposed framework would lower the threshold for obesity, taking into account factors such as waist-to-height ratio and weight-related complications like high blood pressure and diabetes. The changes, published in the Nature Medicine journal, state: "The basis for this change is the recognition that BMI alone is insufficient as a diagnostic criterion, and that body fat distribution has a substantial effect on health."
The alterations aim to address a large group of Brits currently deemed healthy, with the goal of "reducing the risk of undertreatment in this particular group of patients in comparison to the current BMI-based definition of obesity".
The report also emphasised that the BMI index fails to reflect the "severity of the disease" in patients and criticised the clinical processes and management of obesity compared to other chronic diseases. The changes would also include personalised therapeutic targets.
The coalition suggested that companies and organisations, including the NHS, might want to adopt the new framework. The NHS currently uses BMI as a criterion for patients to access certain obesity medications, such as Semaglutide, found in drugs like Wegovy.
The BMI system, which has been in use for nearly two centuries, is once again under scrutiny. Critics argue that it fails to distinguish between fat and muscle mass.
For instance, a physically fit rugby player with a high muscle mass could have the same height and weight measurements as an overweight individual leading a sedentary lifestyle. Despite their vastly different body compositions, both could be categorised as obese according to the current BMI formula.