For decades, doctors have used body mass index (BMI) as a tool to measure obesity. BMI is defined as a measure of body fat by dividing a person’s weight in kilograms by the square of his height. A person with a BMI over 30 is generally considered obese.

However, doctors have said that sometimes, people with excess body fat do not always have a BMI higher than 30, which means their health risks may go unnoticed. Therefore, India’s top experts 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 All India Institute of Medical Sciences (AIIMS) have provided guidelines for the treatment of obesity. and 15 years after diagnosis, similar to the new definition released by The Lancet Diabetes & Endocrinology on January 15.

“This study gives Indians a unique, targeted approach to combat obesity and related diseases,” said Dr Naval Vikram, Department of Medicine, AIIMS.

Although excess body fat can cause health problems, obesity is often viewed as a warning sign for other diseases rather than a disease itself. This idea is still under debate.

Furthermore, using 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 does not give a complete picture of a person’s health.

new definition of obesity

Lancet researchers define clinical obesity as a state of disease, similar to the notion of chronic disease in other medical specialties, that directly results from the effects of excess fat on the function of organs and tissues.

Why was there a need for new guidelines for Indians?

According to Indian doctors and researchers, there was a need for new definition and guidelines for obesity due to several factors.

Old BMI Criteria: The old guidelines from 2009 relied solely on BMI (weight-to-height ratio) to diagnose obesity. Research now shows that 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.

Obvious Risks: The new guidelines distinguish “harmless obesity” from obesity that causes health problems.

Major changes in the new guidelines

Pay attention to belly fat: Belly fat is now an important factor in the diagnosis of obesity because of its association with insulin resistance and other conditions.

Health problems matter: The definition includes obesity-related issues such as diabetes, heart disease and joint pain.

Two-Step Classification:

Stage 1 Obesity: Increased adiposity (BMI > 23 kg/m²) without apparent effect on organ functions or routine daily activities. This stage of obesity, not currently causing any pathological problems (“harmless obesity”), can progress to Stage 2 obesity, which is associated with mechanical and pathological problems.

Stage 2 Obesity: Advanced obesity status with increased BMI greater than 23 kg/2, and abdominal fat, excess waist circumference (WC) or waist-to-height ratio (W-HTR). One of these impacts physical and organ function: mechanical conditions (such as knee arthritis caused by being overweight) or the presence of diseases associated with obesity (such as type 2 diabetes).

The above stage shows that obesity hinders the functions of body organs and makes individuals more symptomatic, which requires more intensive management.

The guidelines were developed using the Delphi process, which is a method of building expert consensus. Five surveys were conducted from October 2022 to June 2023.

Dr. Anoop Mishra of Fortis Hospital said that since obesity is increasing rapidly across India, the new guidelines are simple, practical and allow early intervention to prevent health problems.

The new definition, introduced 15 years after the last update, provides a clear and practical framework for the diagnosis and management of obesity in India. By focusing on Indian-specific traits, it aims to curb the growing obesity epidemic and related conditions like diabetes.