Mass General Brigham recommends change in how we look at obesity
Mass General Brigham
A newly proposed definition of obesity could significantly increase the number of Americans considered to have the condition. According to researchers at Mass General Brigham, applying updated criteria developed earlier this year by the Lancet Diabetes and Endocrinology Commission raises the estimated obesity rate in the United States from about 40 percent to nearly 70 percent.
The study examined data from more than 300,000 people and found
that the increase was especially pronounced among older adults. The findings
also showed that many individuals newly classified under the updated definition
face higher risks of serious health problems. The study was published in JAMA
Network Open.
"We already thought we had an obesity epidemic, but
this is astounding," said co-first author Lindsay Fourman, MD, an
endocrinologist in the Metabolism Unit in the Endocrinology Division of the
Mass General Brigham Department of Medicine. "With potentially 70 percent
of the adult population now considered to have excess fat, we need to better
understand what treatment approaches to prioritize."
Why BMI Alone May Miss Health Risks
For decades, obesity has primarily been defined using body
mass index (BMI), a calculation based on height and weight. While BMI offers a
simple estimate, it does not capture how fat is distributed throughout the
body. Other anthropomorphic measures -- including waist circumference,
waist-to-height ratio, and waist-to-hip ratio -- can provide additional insight
by distinguishing fat mass from muscle and identifying abdominal fat linked to
disease risk.
Under the updated framework, obesity is identified in two main ways. Individuals with a high BMI plus at least one elevated anthropometric measure are classified as having obesity, a category the authors call "BMI-plus-anthropometric obesity." People with a normal BMI can also be classified as having obesity if they have at least two elevated anthropometric measures, referred to as "anthropometric-only obesity."
The guidelines further separate obesity into preclinical and
clinical forms, with clinical obesity defined by obesity-related physical
impairment or organ dysfunction. The new standards have already been endorsed
by at least 76 organizations, including the American Heart Association and The
Obesity Society.
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