Obesity diagnosis presents new diagnostic criteria for BMI alone
Feb 13, 2025
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It is said that a comprehensive diagnosis should be introduced considering the effects on long-term and tissue functions, away from the existing body mass index (BMI)-centered evaluation method. This study is expected to change the paradigm of obesity treatment and public health policy.
A committee of 58 multidisciplinary experts selected from several countries around the world comprehensively reviewed existing scientific evidence to help in clinical decision-making, treatment prioritization, and public health strategies for obesity diseases. In Korea, Professor Lim Soo of the Department of Endocrine Metabolism at Seoul National University Bundang Hospital participated as a representative.
Until now, obesity has been regarded as simply overweight or recognized only as a risk factor for diabetes or cardiovascular disease. However, the committee defined obesity as a 'chronic and systemic disease condition in which excessive body fat mass leads to abnormal deterioration in the function of body organs. Obesity itself is a chronic and systemic disease that causes damage to body organs and tissues, and can cause life-threatening complications such as heart attack, stroke, and heart failure. In particular, he emphasized the need for a treatment strategy suitable for each by dividing obesity into 'Clinical Obesity' and 'Clinical Obesity'.
'Clinical obesity disease' refers to a condition that can cause life-threatening complications such as heart attack, stroke, and kidney failure due to excessive body fat. 'Clinical Obesity Pre-stage' refers to a condition in which organ function is still normal, but there is a high risk of developing diabetes and cardiovascular disease. Although the risk of death and obesity-related diseases caused by increased body fat may increase continuously, it is said that distinction is necessary for clinical and policy purposes.
The committee noted that body mass index (BMI) does not accurately reflect an individual's health status. BMI is simply a calculation method using height and weight, and there is a limitation in that it does not reflect an individual's fat distribution or physical dysfunction. As a result, there may be an error in diagnosing healthy people as obese or, conversely, considering people with health threats as normal.
Accordingly, BMI is only used as a population-level health risk assessment or screening test tool, and it is recommended that body fat be measured directly or additional body measurement methods (waist circumference, waist-hip ratio, waist-height ratio, etc.) should be combined in addition to BMI for individual diagnosis. However, if the BMI is high above 40 kg/㎡, excessive body fat is clear, so no additional test is necessary.
The committee also presented specific criteria for diagnosing clinical obesity. ▲ Evidence of reduced function of important organs due to obesity, ▲ Restrictions on basic physical activities or daily activities (bath, clothes, toilet use, self-defecation, self-eating) due to obesity, and if more than one of these is identified, it can be diagnosed as clinical obesity.
In particular, the study emphasized that obesity is not a simple lifestyle problem, but a disease that requires treatment. Obesity is a disease caused by a combination of factors such as heredity, hormones, and environmental factors, and he warned that weight-based discrimination and stigma can be an obstacle to effective prevention and treatment.
Since obesity is likely to develop into a serious health problem, active treatment intervention in time is needed, and drug and surgical treatment should be actively considered as well as lifestyle improvement. In addition, people in the pre-clinical stage of obesity should take appropriate measures to lower the risk of developing obesity, including health counseling and monitoring of health conditions.
Professor Lim Soo of Seoul National University Bundang Hospital said, `Bias and stigma that attribute obesity only to individuals are obstacles to effective prevention and treatment of obesity diseases"It is necessary to establish a public health strategy based on scientific evidence" he stressed.
The study was based on a high level of agreement among 58 international experts who participated in the committee and was supported by 75 medical societies and patient organizations around the world.
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This article was translated by Naver AI translator.
