Obesity's new spin: is it time to say 'bye BMI'?

Doctors and fitness experts are using metrics such as BP, body fat percentage and waist-to-hip ratio to assess a person's health

- Shrenik Avlani

Obesity has a brand new definition now. This new description of the lifestyle disease—which goes beyond the currently accepted BMI (body-mass index) norms—has been proposed in a new report published in the The Lancet Diabetes & Endocrinology journal in early January. A multinational commission of doctors and experts, which included Dr Anoop Misra, executive chairman and director of diabetes and endocrinology at Fortis C-DOC Hospital in Delhi, in the report, titled Definition and Diagnostic Criteria of Clinical Obesity, noted that clinical obesity should be treated as an "illness that, akin to the notion of chronic disease in other medical specialties, directly results from the effect of excess adiposity on the function of organs and tissues."

The understanding of obesity has evolved significantly over the past few decades, with particular attention to ethnic differences, says Misra. "In 2009, India introduced revised definitions of obesity specifically for Asian Indians. This revision acknowledged that Asian Indians typically have higher body fat percentages than Western populations and develop diabetes at lower BMI levels."

Those new guidelines, Misra notes, set lower thresholds and established waist circumference thresholds. "Men with a waistline larger than 90 cm and women with waists greater than 80 cm, lower than Western standards of 102 cm and 88 cm respectively, were considered obese," says Misra, noting that contemporary approaches to obesity have moved beyond simple BMI measurements.