New Delhi: Health experts have highlighted the limitations of Body Mass Index (BMI) as a standalone screening tool for obesity, stating that body fat measurement is crucial for confirmation. This announcement coincides with India revamping its obesity guidelines after 15 years to better address the country’s rising obesity burden.
Traditionally, BMI has been used to define obesity, but a team of doctors has redefined it based on the unique body composition of the Indian population. Experts pointed out that obesity is a growing concern with the potential to overwhelm India’s healthcare systems. They stressed the importance of moving beyond BMI-based approaches to address the rising prevalence of obesity and associated health risks.
The revised guidelines, published in The Lancet Diabetes and Endocrinology, emphasize abdominal obesity and comorbidities over BMI alone. According to Dr. Naval Vikram, Professor of Medicine at AIIMS, New Delhi, the new definition categorizes obesity into two stages: preclinical and clinical.
Preclinical obesity is characterized by the accumulation of adipose tissue without functional abnormalities in body organs. While this state may be temporary, it carries the risk of progressing to clinical obesity, which is defined as a chronic systemic illness. Clinical obesity involves dysfunction in organ systems such as metabolic, mechanical, and cardiorespiratory systems due to excess adipose tissue.
Dr. Vikram noted that BMI remains useful for screening but should be supplemented by body fat measurements or alternatives like waist circumference, waist-to-hip ratio (WHR), or waist-to-height ratio to confirm obesity.
India’s earlier guidelines, set in 2009, relied heavily on BMI, neglecting the unique body composition of Indians. Research has shown that health risks can emerge at lower BMI levels in Indian individuals, necessitating revised cut-offs. Dr. Vikram added that the new cut-offs might also consider factors like gender and ethnicity for better accuracy.
Dr. Anoop Misra, Executive Chairman and Director of Diabetes and Endocrinology at Fortis C-DOC Hospital, highlighted the significant implications of redefining obesity. He noted that India has seen a doubling in obesity prevalence over the past two decades, with abdominal obesity becoming increasingly common. Rising childhood obesity rates and associated conditions such as diabetes, lipid disorders, fatty liver disease, and cardiovascular disease further underscore the need for updated approaches.
According to IANS, experts believe that shifting beyond BMI-based methods will help prevent both under- and over-diagnosis of obesity-related health risks. The revised frameworks enable more precise, personalized treatments by considering individual metabolic profiles and risk factors.
The experts also linked poor eating habits, including reliance on packaged foods and a decline in home-cooked meals, as contributors to obesity. Increased sedentary lifestyles, exacerbated by higher screen time and reduced physical activity opportunities, were also flagged as concerns.
To tackle obesity, they advised consuming a balanced diet rich in macro- and micronutrients, avoiding high-fat, salt, and sugar-laden foods, and maintaining regular physical activity. These measures, combined with personalized treatment strategies, could help curb the growing obesity epidemic in India.