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Redefining Obesity

Writer's picture: Tom RogulaTom Rogula

Updated: Jan 20


Despite many attempts, obesity remains challenging to define as a disease. Using the traditional Body Mass Index (BMI) is controversial as it may underestimate or overestimate the problem. Even more contentious is to describe obesity as an independent chronic disease or a consequence of excessive adipose tissue deposit on all organs and systems. Many can argue that obesity alone (i.e., excessive fat deposition without related diseases) can be called a disease. Such a state fits into "preclinical" obesity, whereas clinical obesity includes progressive end-organ damages and diseases related to obesity (diabetes mellitus 2 type, cardiovascular problems, etc.). BMI, used as a measurement of health, underestimates many essential aspects and may not reflect ongoing severe damage to vital organs and systems.


In recently published Recommendations, Prof. Francesco Rubino and colleagues propose that "BMI should be used only as a surrogate measure of health risk at a population level, for epidemiological studies, or screening purposes, rather than as an individual measure of health." This Lancer paper recommends defining clinical obesity as a condition in which functions of key organs and systems were reduced due to obesity, or there are "significant age-adjusted limitations of daily activities reflecting the specific effect of obesity on mobility," or both. These patients should receive appropriate treatment to stop progressing or reverse their conditions, whereas patients with preclinical obesity require consultations and interventions to prevent them from progressing to clinical obesity. The Recommendations emphasized the importance of bias and stigma-free efforts to prevent obesity at the population level.


Please follow this link to read more and watch an exclusive interview with Prof. Francesco Rubino at the IBC World Congress at Oxford University in September 2024.




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