When “more precise” and “nuanced” definitions are needed, there is a risk that too many people are being diagnosed with obesity, A report from global experts They say.

It says doctors should consider the overall health of patients with excess fat, rather than just measuring their body mass index (BMI).

People who have chronic diseases because of their weight should be diagnosed with ‘clinical obesity’ – but those who have no health problems should be diagnosed with ‘pre-clinical obesity’.

It is estimated that more than a billion people worldwide are living with obesity and there is a huge demand for prescription weight loss medications.

The report, published in The Lancet Diabetes and Endocrinology journal, has the support of more than 50 medical experts from around the world.

“Obesity is a spectrum,” says Professor Francesco Rubino of King’s College London, who chairs the group.

“Some people have it and they manage to live normal lives, function normally.

“Others can’t walk well or breathe well, or are wheelchair-bound because of significant health problems.”

The report calls for a “reframing” of obesity to differentiate between patients with a disease and those who remain healthy but are at risk of developing the disease in the future.

Currently, in many countries, obesity is defined as BMI over 30 – A measurement that estimates body fat based on height and weight.

Access to weight loss drugs like Vegovi and Monjaro is often limited to this category of patients.

In many parts of the UK, the NHS also requires people to have a weight-related health condition.

But the report says BMI tells nothing about a patient’s overall health, and fails to distinguish between muscle and body fat or account for the more dangerous fat around the waist and limbs.

Experts argue for a new model that looks at the symptoms of obesity affecting organs in the body – such as heart disease, shortness of breath, type 2 diabetes or joint pain – and their harmful effects on daily life.

This indicates that obesity has become a clinical disease and requires drug treatment.

However, people with ‘pre-clinical obesity’ should be offered weight loss advice, counseling and monitoring rather than drugs and surgery to reduce the chance of developing health problems. Treatment may also be necessary.

“Obesity is a health risk – the difference is that for some people it is also a disease,” Professor Rubino said.

He said it would be wise to redefine it to understand risk levels in a larger population rather than the current “blurry picture of obesity”.

The report said waist-height ratio or direct fat measurement, combined with a detailed medical history, could give a clearer picture than BMI.

Professor Lewis Bauer, a pediatric obesity expert at the University of Sydney who contributed to the report, said the new approach would allow obese adults and children to “receive more appropriate care”, while reducing the number of over-diagnosis and unnecessary treatments. . ,

At a time when drugs capable of reducing body weight by up to 20% are being prescribed on a large scale, the report said this “reframing” of obesity is “even more relevant” because it “increases the accuracy of diagnosis Improves”.

The Royal College of Physicians said the report laid a strong foundation “for treating obesity with the same clinical rigor and compassion as other chronic diseases.”

Differentiating between pre-clinical and clinical obesity “would be an important step forward” and “highlights the need to identify and intervene early” while providing the right care to patients whose health is already seriously compromised, the college said. Was impressed.

But there are concerns that pressure on health budgets could mean less money for people in the ‘pre-obese’ category.

Professor Sir Jim Mann, co-director of the Edgar Diabetes and Obesity Research Center in Otago, New Zealand, said the emphasis was likely to be “on the needs of those who are clinically defined as obese” and that limited funding would be “very ” Is. “Chances are” will be directed towards them.