Indian doctors have updated obesity guidelines and redefined the meaning of the medical term. These guidelines have been updated after 15 years condemning the standard BMI tool that has been used for years to diagnose obesity.

BMI or body mass index is calculated as the ratio of weight in kilograms to height in meters squared (kg/m2). For clinical purposes, individuals with a BMI less than 18.5 are classified as “underweight”. The range of “normal weight” is between 18.5 and 24.5, while a BMI of 24.5 to 30 is classified as “overweight.” A BMI above 30 is considered “obese”.

It is a simple device that has previously been shown to be a strong determinant of blood pressure and type 2 diabetes.

While BMI with a cutoff point can tell whether a person is overweight and obese, it has been criticized by doctors as a flawed metric. One reason for this is that BMI does not distinguish between fat and muscle.

A person with a high BMI of 30 and above, who falls into the obese category, may have more muscle mass rather than fat storage. Furthermore, BMI does not take into account a person’s lifestyle and overall health.

According to Dr RR Dutta, Internal Medicine, Paras Health, Gurugram, “This new approach to diagnosing obesity represents a much-needed development in the way we understand and manage this condition. BMI has long been used as a “It has been used as a simple solution, but it is not.” It tells the whole story of a person’s health.”

Experts from the National Diabetes Obesity and Cholesterol Foundation (N-DOC), Fortis C-DOC Hospital and All India Institute of Medical Sciences (AIIMS) have released new guidelines to help diagnose obesity using waist circumference (WC). Provide several metrics for. ), waist-to-height ratio (W-HTR), abdominal fat (excessive fat around the abdomen and stomach), and BMI greater than 23 kg/m2.

This is in line with the new definition given by Lancet researchers on January 15 as “a state of disease, similar to the notion of chronic disease in other medical specialties, that results directly from the effects of excess fat on the function of organs and tissues.” “

According to current guidelines, a BMI greater than 23 is the new determinant to understand that a person has more than the prescribed limit of body fat. Furthermore, WC and W-HtR can be used to define abdominal obesity. Indian researchers said the use of these measures is optional but desirable.

Here is a two-stage classification of obesity:

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

Stage 2 Obesity: Advanced obesity status with increased BMI more than 23 kg/m2 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).

Dr. Dutta, who was not involved in the study, said that by introducing measures such as waist circumference and categories such as clinical and pre-clinical obesity, “we can better tailor care to each individual’s needs.” “can ensure early intervention for those at risk and evidence-based treatment for those with more serious complications.”

Given that obesity is a complex condition with wide-ranging effects, ranging from metabolic and cardiovascular disease to bone health, fertility, and even mental well-being, doctors sought to address this nuanced problem by using a Delphi process. suggested, which is a method of creating expert consensus. Five surveys were conducted from October 2022 to June 2023.

“This nuanced approach allows us to move beyond a one-size-fits-all diagnosis, allowing appropriate allocation of health care resources and prioritization of treatments,” said Dr. Dutta.

lifestyle changes

Managing obesity in both stage 1 and stage 2 requires lifestyle interventions, according to Indian experts who published guidelines in Diabetes and Metabolic Syndrome: Clinical Research and Reviews.

Evaluating obesity requires gathering a detailed medical history, performing a physical examination, and ordering necessary tests. This process rules out secondary causes of obesity and identifies associated health conditions.

For stage 1 obesity, focus on personalized nutrition plans, regular physical activity, and behavior modification. These steps are often enough to reduce the risk of progressing to stage 2 obesity.

For stage 2 obesity, persistent and intensive lifestyle changes are necessary. This involves a daily calorie deficit of approximately 500 kcal through diet and 60 minutes of exercise every day.