New Delhi, Jan 18: Body Mass Index (BMI) can be a screening tool, but obesity must be confirmed by measuring body fat, said health experts on Saturday, even as India revamped its obesity guidelines after 15 years.
Traditionally BMI was used to define obesity, but a team of doctors redefined obesity based on the Indian population.
Noting obesity as a serious concern in the country, with the potential to overwhelm healthcare systems, the experts, part of the redefining team, called it essential to move beyond BMI-only approaches to tackle the ever-growing people related to other major health risks.
The new approach, published this week in the Lancet Diabetes and Endocrinology, focuses on abdominal obesity and comorbid diseases, rather than just BMI. "The new definition of obesity primarily categorises obesity into pre-clinical and clinical obesity," Dr. Naval Vikram, Professor of Medicine, at AIIMS, New Delhi, told IANS.
The expert explained that preclinical obesity is an accumulation of adipose tissue without any abnormalities in the functions of body organs. This state may be temporary and may convert to clinical obesity in the future and have an increased risk of developing several obesity-related diseases. On the other hand, clinical obesity is defined as a chronic systemic illness with abnormalities in the functions of organ systems (metabolic, mechanical, cardiorespiratory, etc) due to excess adipose tissue, Vikram said.
"BMI should be used for screening purposes, but obesity should be confirmed ideally by a measure of body fat wherever feasible, or another measure such as waist circumference, WHR, or Waist-to-height ratio," the doctor added.
As per the 2009 criteria, the reliance was on BMI without considering the unique body compositions of Indians. Research shows that health risks may manifest in individuals with a BMI lower than 30, necessitating revised cut-offs for accurate diagnosis.
Vikram said the new cutoff points may be defined based on gender and ethnicity. Those with clinical obesity should receive appropriate treatment for the condition, whereas those with preclinical obesity need adequate counselling and interventions to prevent the development of clinical conditions.
Dr. Anoop Misra, Executive Chairman & Director of Diabetes and Endocrinology at Fortis C-DOC Hospital said that the evolution in obesity definition and classification carries significant implications. Misra noted that India has experienced a doubling of obesity prevalence over the past two decades, with abdominal obesity becoming particularly prevalent.
Childhood obesity rates are rising significantly across the nation. The country has also seen concurrent increases in related conditions including diabetes, lipid disorders, fatty liver disease, and cardiovascular disease.
In such a scenario, "moving beyond BMI-only approaches helps prevent both under- and over-diagnosis of obesity-related health risks," Misra said.
"The new frameworks enable more precise, personalised treatment strategies that consider individual metabolic profiles and risk factors," he added.
The experts also pointed out the poor eating habits -- increasing consumption of packaged food and decreased emphasis on home-cooked food; an increase in sedentary habits, which may be due to a rise in screen time (leisure or work-related) and shrinking open areas or opportunities for physical activity.
They advised people to avoid foods high in fat, salt, and sugar to prevent obesity; and to eat a balanced diet, with an appropriate amount of macro- as well as micro-nutrients, preferably home-cooked.
(Rachel V Thomas can be contacted at rachel.t@ians.in)
