New Obesity Definition and Diagnosis for India

Source: The post New Obesity Definition and Diagnosis for India has been created, based on the article “New definition for obesity? What a new Lancet commission has proposed to replace BMI” published in “Indian Express” on 17th January 2025

UPSC Syllabus Topic: GS Paper2- Governance-Issues relating to development and management of Social Sector/Services relating to Health

Context: The article discusses a new definition and method for diagnosing obesity proposed by The Lancet Commission. It moves beyond BMI and includes other measurements to assess excess body fat and related health risks. The approach also considers specific needs for Indian populations.

For detailed information on Lancet study on Global Obesity rates read this article here

What is the new definition of obesity?

1. The Lancet Diabetes & Endocrinology Commission, composed of 58 experts, has proposed a new definition of obesity that goes beyond the Body Mass Index (BMI).
2. This definition includes additional measures like waist circumference and muscle mass assessments to provide a more accurate diagnosis of obesity.
3. The traditional BMI cutoffs have proven inadequate because they could misclassify the health status of individuals with different body compositions. For instance, people with high muscle mass might be categorized as obese under BMI metrics, even if they are healthy.

What Does the New Definition Include?

1. Preclinical Obesity: Identified as excess body fat without associated illnesses. It may or may not progress to clinical obesity. For example, some Indians with a BMI under 30 may have abdominal fat affecting organ function.
2. Clinical Obesity: Defined as a chronic illness that alters organ functions and leads to life-altering or life-threatening complications.
3. Measurements Used: BMI is supplemented with waist circumference, waist-to-hip ratio, or waist-to-height ratio. Two of these measures are recommended for accuracy.
4. Advanced Diagnostics: Methods like DEXA scans directly measure body fat for precise assessments.

How Will Obesity Be Treated Under the New Guidelines?

1. Treatment strategies for Preclinical Obesity focus on preventing disease progression through lifestyle changes and regular monitoring.
2. Clinical Obesity requires personalized, evidence-based treatments, potentially including new medications or surgeries, depending on the severity of symptoms and health conditions.

How Are Indians Specifically Addressed?

1. Lower BMI Cutoffs: Indian guidelines define overweight at BMI 23–24.9 and obesity at BMI over 25 due to higher health risks at lower BMI compared to Western populations.
2. Higher Body Fat Percentage: Indians have higher central obesity, making them prone to diabetes, hypertension, and heart diseases even at lower BMI levels.
3. Stage-Based Classification: Obesity is classified into Stage 1 (no significant symptoms) and Stage 2 (symptoms affecting daily life or comorbidities).
4. Familiarity with BMI: BMI remains the entry point for diagnosis in India for easier implementation.
5. Expert Insight: Expert highlighted Indians’ unique risks, linking obesity to chronic conditions despite lean appearances.

For detailed information on Obesity in India read this article here

Question for practice:

Examine how the new definition of obesity proposed by The Lancet Commission addresses the specific health risks and needs of Indian populations.