Focus on Fat over BMI - Lancet Reports!

Lancet commission recommends on fat focus

An escalating global epidemic of overweight and obesity – “globesity” – is taking over many parts of the world. Lancet commission recommends on fat focusUnsplash

Published on:

20 Jan 2025, 3:05 pm

The severity of obesity is increasing day by day among people and countries without any bias.

Obesity

Obesity is a chronic complex disease defined by excessive fat deposits that can impair health.

An escalating global epidemic of overweight and obesity – “globesity” – is taking over many parts of the world.

World Health Organisation

Obesity can increase the risk of type 2 diabetes and heart disease, negatively impact bone health and reproduction, and even elevate the risk of certain types of cancer. It also affects the quality of life by making activities like sleeping and moving more difficult, ultimately complicating daily living. ^[1][2]

In 2022, 1 in 8 people in the world were living with obesity.

World Health Organisation

The easy detection of BMI by dividing an adult's weight in kilograms by their height in meters squared (weight (kg)/height² (m²)) has made it popular among healthcare professionals and the public. According to BMI, an increase in BMI corresponds to increased health risks, and individuals are classified as obese. ^[2]

However, the Lancet Diabetes and Endocrinology Commission, in its recent report on obesity, has proposed a different perspective on calculating and considering fat as the basis for identifying obesity.

The study by the Lancet Commission included 56 leading experts from high-income, middle-income, and low-income countries, representing a broad range of expertise to define obesity by considering factors beyond BMI.

The Commission uses additional measurements of body size, such as waist circumference, waist-to-hip ratio, or waist-to-height ratio, alongside BMI, to define obesity status and establish an objective criterion for diagnosing obesity.

This evidence-based definition clearly differentiates “clinical obesity”—a chronic, systemic disease state directly caused by excess adiposity—from “preclinical obesity”, which is characterized by excess adiposity without current organ dysfunction or limitations in daily activities but with an increased future health risk. ^[4]

People with clinical obesity should receive timely, evidence-based treatment, with the aim to induce improvement (or remission, when possible) of clinical manifestations of obesity and prevent progression to end-organ damage. People with preclinical obesity should undergo evidence-based health counselling, monitoring of their health status over time, and, when applicable, appropriate intervention to reduce risk of developing clinical obesity and other obesity-related diseases, as appropriate for the level of individual health risk.

Lancet Diabetes and Endocrinology Commission

Causes of obesity: ^[3]

Imbalance of energy intake (diet)
Energy expenditure (physical activity)
Medications
Diseases
Immobilization
Iatrogenic procedures
Monogenic disease/genetic syndrome
Obesogenic environment
Psycho-social factors

The lack of an effective health system response to identify excess weight gain and fat deposition in their early stages is aggravating the progression to obesity.

World Health Organisation

Issues Caused by Obesity:

Increased risk and earlier onset of various NCDs, such as type 2 diabetes and cardiovascular disease.
Childhood and adolescent obesity negatively impacts school performance and quality of life, further exacerbated by stigma, discrimination, and bullying.
Global costs of overweight and obesity are projected to reach US$3 trillion per year by 2030 and more than US$18 trillion by 2060. ^[1]

WHO emphasis on importance of measures to be taken to tackle obesityUnsplash

Prevention of obesity:

The DASH Eating Plan includes recipes and flexible meal plans that limit foods high in saturated fat, sugar-sweetened beverages, sweets, and sodium.
The Aim for a Healthy Weight program offers healthy weight tools such as menu plans and tips for controlling weight, eating right, and staying physically active.
We Can! (Ways to Enhance Children’s Activity and Nutrition) provides healthy weight resources for parents to help establish healthy habits as a family.

If immediate action is not taken, millions will suffer from an array of serious health disorders.

WHO emphasis the importance of measures to be taken to control the menace of obesity across the world.

References:

[1] World Obesity Federation, RTI International, and A Okunogbe et al. 2022. The Economic Impact of Overweight & Obesity in 2020 and 2060. The Economic Impact of Overweight & Obesity. World Obesity Federation. https://data.worldobesity.org/publications/WOF-Economic-Impacts-2-V2.pdf. 18.01.2025.

[2] "Prevention | NHLBI, NIH.” 2022. NHLBI, NIH. March 24, 2022. https://www.nhlbi.nih.gov/health/overweight-and-obesity/prevention. 18.01.2025.

[3] World Health Organization: WHO. 2024. “Obesity and Overweight.” March 1, 2024. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. 18.01.2025.

[4] The Lancet Diabetes & Endocrinology. "Acknowledging the Obstacles and Knowledge Gaps in Addressing Clinical Obesity." Accessed January 20, 2025. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(25)00004-X/fulltext#:~:text=Acknowledging%20the%20obstacles%20and%20knowledge,alone%20illness%20(clinical%20obesity).

(Input from various sources)

(Rehash/Dr . Jude Bencia. G/MSM)

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