For decades, doctors have used body mass index (BMI) as a tool to measure obesity. BMI is defined as a measure of body fat based on a person's weight in kilograms divided by the square of their height in metres.
A person with their BMI over 30 is usually considered obese.
However, doctors have said that sometimes, people with excess body fat don't always have a BMI over 30, which means that their health risks can go unnoticed. Therefore, top experts from India have redefined obesity for Indians in a landmark study, addressing the unique health challenges faced by the population.
Experts, such as doctors, surgeons, physiotherapists, and nutritionists from the National Diabetes Obesity and Cholesterol Foundation (N-DOC), Fortis C-DOC Hospital, and the All India Institute of Medical Sciences (AIIMS), have provided guidelines for obesity treatment and diagnosis after 15 years, similar to the new definition released by The Lancet Diabetes and Endocrinology on January 15.
"This study gives Indians a unique, targeted approach to tackle obesity and related diseases," said Dr. Naval Vikram, Department of Medicine, AIIMS.
Although excess body fat can cause health problems, for other diseases rather than a disease itself. This idea is still debated.
Besides this, using the BMI (body mass index) which has always been the standard measurement of obesity has its flaws - it can either overestimate or underestimate body fat and doesn't give a full picture of an individual's health.
NEW DEFINITION OF OBESITY
Lancet researchers defined clinical obesity as a condition of illness that, akin to the notion of chronic disease in other medical specialities, directly results from the effect of excess adiposity on the function of organs and tissues.
WHY NEW GUIDELINES WERE NEEDED FOR INDIANS
As per Indian doctors and researchers, were needed due to several factors.
Outdated BMI Criteria: The old 2009 guidelines relied solely on BMI (a weight-to-height ratio) to diagnose obesity. Research now shows BMI alone is not enough, especially for Indians.
Abdominal Obesity: Studies reveal a strong link between belly fat, inflammation, and early health problems in Indians.
Clarifying Risks: The new guidelines separate "harmless obesity" from obesity that causes health issues.
KEY CHANGES IN THE NEW GUIDELINES
Focus on Belly Fat: Abdominal fat is now a key factor in diagnosing obesity due to its link to insulin resistance and other conditions.
Health Problems Matter: The definition includes obesity-related issues like diabetes, heart disease, and joint pain.
Two-Stage Classification:
Stage 1 Obesity: Increased adiposity (BMI > 23 kg/m²) without apparent effects on organ functions or routine daily activities. This stage of obesity, currently not causing any pathological problems ("Innocuous obesity"), could progress to Stage 2 obesity, which has association with mechanical and disease related problems.
Stage 2 Obesity: Advanced state of obesity with increased BMI more than 23 kg/2, and abdominal adiposity, excess Waist Circumference (WC) or Waist-to-Height Ratio (W-HtR). One of these impacts physical and organ functions: mechanical conditions (such as knee arthritis due to excess weight) or the presence of diseases associated with obesity (such as type 2 diabetes).
The above stage shows that obesity hinders the functions of organs of the body and makes individuals more symptomatic, requiring more intensive management.
The guidelines were developed using the Delphi process, a method for building expert consensus. Five surveys were conducted from October 2022 to June 2023.
Dr Anoop Misra from Fortis Hospital said that since obesity is rising quickly across India, the new guidelines are simple, practical, and allow early interventions to prevent health problems.
The new definition, introduced 15 years after the last update, offers a clear and practical framework to diagnose and manage obesity in India. By focusing on Indian-specific traits, it aims to curb the growing obesity epidemic and related conditions like diabetes.
