Almost 70% of US adults would be deemed obese based on new definition, study finds

"In an effort to tackle the issue, in January medical experts from around the world called for a new definition to be adopted. This would encompass people either with a BMI greater than 40; or those with a high BMI and at least one raised figure for measures such as waist circumference, waist-to-hip ratio, or waist-to-height ratio; or those with two such raised figures regardless of BMI; or those with direct measures of excess body fat based on scans."

"Now research suggests the revamped definition could result in a dramatic rise in the prevalence of obesity among adults in the US. Dr Lindsay Fourman, the first author of the study, from Mass General Brigham in the US, said the increase in obesity prevalence based on the new definition was striking, and was largely driven by people who would not have been considered to have obesity based on their BMI alone."

"Recognising people with [this type of] obesity can lead to more accurate health risk stratification, she said. For example, someone with BMI 23 but excess abdominal fat could benefit from lifestyle interventions such as improving diet and increasing physical activity, even though their BMI is in the normal range. Their physician might also more closely monitor for obesity-related complications such as pre-diabetes or fatty liver."

A proposed obesity definition expands classification beyond BMI to include severe BMI, combinations of BMI and abdominal measures, paired elevated abdominal measures regardless of BMI, or direct body-fat scans. The proposal also separates obesity into clinical obesity with signs of illness and pre-clinical obesity without such signs. When applied to a nationally representative sample of 301,026 adults aged 18–80, the new definition classifies almost 70% of US adults as having obesity. Much of the increase comes from people with normal-range BMI but excess abdominal fat. Identifying these individuals enables targeted lifestyle interventions and closer monitoring for complications like pre-diabetes and fatty liver.

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