Leading medics said that a body mass index (BMI) score is not “nuanced” enough to measure obesity and more assessments are needed before someone is told they are obese.
Solely using BMI can lead to both overestimates and underestimates of the number of obese people, they said.
In a briefing to journalists, the team said that a “blanket definition does not reflect reality” and leads to over diagnosis, “leading to unwarranted use of surgical operations, devices and drugs”.
But surgeon Francesco Rubino, chair of bariatric and metabolic surgery at King’s College London – who chairs the commission – said the obesity “landscape” had changed since it was formed five years ago due to the dawn of weight-loss jabs.
“If you have one million people, and sometimes 30-40 per cent of the population [classified as obese], it’s important to understand if that problem requires immediate active treatment – by pathological intervention or by simply monitoring and giving good advice on lifestyle intervention.
The commission said that “BMI is useful but we need to go beyond BMI to determine excess body fat” and that the measurement tool should be used only as a “surrogate measure of health risk”.
The UK currently defines obesity as anyone with a BMI of at least 30, or at least 27.5 for certain groups of ethnic minorities (Photo: Getty)Ideally, obesity would be measured using total body fat, but the medics conceded that this would involve clinics “going beyond” what they would usually do to identify obese people because it can include more expensive and time-consuming body scans – with the NHS suffering a shortage of scanners and staff trained to use them.
Firstly clinical obesity – defined as a “chronic systematic illness” whereby excess fat can lead to organ damage and cause “life-altering and potentially life-threatening complications”; and secondly, pre-clinical obesity – a “state of excess adiposity” where the person has a variable level of health risk, but no ongoing illness.
“It’s difficult to give a figure [on the number of people who would no longer be considered obese] but we think it will improve accuracy, which is what we need in the clinic.”
“No system – the NHS or others – have had these methods yet – I think everybody has been using the old classification for four decades, at least,” Rubino said.
Tom Sanders, professor emeritus of nutrition and dietetics, King’s College London, said: “The recommendations are helpful because they will help target interventions to those that need them most. The recognition of clinical obesity as disease would hopefully persuade lawmakers to regard it as a disability.
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Read MoreAccording to the latest Health Survey for England, some 29 per cent of adults are obese and 15 per cent of children aged two to 15 are obese.
Regarding the creation of new categories for clinical and pre-clinical obesity, a spokesman said this would need further consideration and debate by the obesity community, and was not something it would comment on at this stage.
“Currently, obesity treatment is inaccessible to those who need it most, namely individuals with the highest levels of excess weight, while our prevention policies remain insufficient.”
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