New obesity definitions reveal ill health more accurately than body mass index
Traditionally, obesity has been classified primarily using BMI, a measure of weight relative to height that provides limited information about whether excess fat is actually affecting a person's health. BMI levels have historically played a central role in determining eligibility and priority for metabolic bariatric surgery—operations on the stomach that help people lose weight and treat health…
Traditionally, obesity has been measured using BMI, a ratio of weight to height, which does not account for how excess fat may be impacting a person's health. However, a study in JAMA Network Open demonstrated that individuals deemed eligible for metabolic bariatric surgery could exhibit significant differences in the severity of their health conditions and risks from the surgery itself, even if their BMI was the same.
To gain a better understanding of these differences, researchers reviewed clinical data from nearly 2,300 bariatric surgery candidates across four major centers, applying new definitions of obesity: clinical obesity, where excess fat is already causing organ damage, and preclinical obesity, where there is still excess fat but the organs are functioning normally.
The results showed that 73.8% of candidates had clinical obesity, while 26.2% had preclinical obesity. Despite having similar BMI measurements, those with clinical obesity had more severe health issues, placing them at higher risk for complications during surgery and a greater likelihood of dying. Professor Francesco Rubino, the lead researcher, emphasized that this distinction is important because BMI alone cannot determine whether someone has active disease, and future studies should report on clinical or preclinical obesity status to better assess the risks and benefits of surgery.
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