As most of us know, using the Body Mass Index (BMI) scale can be practically useless for many people. There is so much more to us that just Height/Weigh ratio.
New Global Agreement on Measuring Clinical Obesity
The Lancet reports on 58 obesity experts from around the world who got together and developed new ways to diagnose clinical and pre-clinical obesity.
“The report has been endorsed by 76 global medical organizations, including those from the U.S., such as the American Diabetes Association, American Heart Association, American Association for Metabolic and Bariatric Surgery, the American Association of Clinical Endocrinology, the Obesity Action Coalition and The Obesity Society.”
This is an amazing improvement over just using the quite outdated use of the BMI scale.
They propose measuring body fat to decide if a person has obesity or now. Doing that can be a combination of factors, which helps alleviate the One-Size-Fits-All aspect of the BMI.
- Measure waist circumference
- Measure waist-to-hip ratio
- Measure waist to height ratio (BMI)
- Body composition DEXA/DXA Scan
If a person has one of those criteria in the list above plus high BMI, two of the criteria without using BMI, or a DEXA scan showing excess body fat, then that is a clinical diagnosis for having obesity.
An aside: It can be a challenge to find a provider able to use insurance to pay for the (rather inexpensive) body composition DEXA scans. Typical providers that are able to have insurance reimburse them are obesity and sports medicine specialists. My doctor prescribes a Bone Density DEXA scan for me every six months, which does not include a body fat or comprehensive body scan, because I have osteopenia from my RNY Gastric Bypass in 2001. Without the full body DEXA, not just the bone density, clinical obesity cannot be diagnosed. I’m hoping this new information will be adopted, not just by the experts and global associations, but by insurance companies so physicians are able to order them.
I do get a full body DEXA scan once a year to see how my body composition has been changing while on GLP-1s.
Between the nine months , I only lost 7% muscle! I wish I had had a DEXA scan before I started the Trulicity. They are relatively inexpensive. Mine was $125. Most are between $100-$300. Well worth the money.
Difference Between Having Clinical or Pre-Clinical Obesity
From the Helio article:
Adults have preclinical obesity if they have no signs or symptoms of reduced organ or tissue function due to obesity, and they can complete normal, day-to-day activities, according to the paper. Clinical obesity is defined as obesity-related organ or tissue dysfunction or an inability to complete day-to-day activities.
I find this a fascinating distinction. What would be considered an inability to do day-to-day activities? Putting our socks on? Able to walk up a flight of stairs without breathing hard? Without gasping for air? Taking a daily shower? Wipe our bottoms?
Of all the aspects of diagnosing Clinical Obesity, this will be the one that is incredibly difficult to define. I wonder who will be the ones to decide what “day-to-day activities” are. Will it be a scientist, researcher, or doctor who does not have Obesity themselves? Or will they incorporate people like me who could barely leave their beds for years?
I will be watching this closely.
If you have thoughts about this possibly upcoming way to diagose Obesity and Pre-Clinical Obesity, please leave them in the comments.
Forgive the analogy, but I feel like diagnosing obesity is kind of like classifying porn: I know it when I see it… mostly. I know for a fact that I was obese. The BMI chart says that I still am. My doctor disagrees. AND, she doesn’t want me to look at that chart nor does she want me to strive for what it says is my “normal” weight. I would love to lose another 20 lbs, but even with that, the BMI chart still says I’m “overweight.” Adolphe Quetelet (1796-1874), the Belgian statistician who established the BMI calculation formula, can kiss my overweight butt!! 😉
I agree on the difficulty on classifying it, but I believe if we don’t find a *clinical* way to diagnose overweight and obesity, then people will still not believe it is a chronic disease and all we need is more willpower to get healthy. I like that this consensus by so many actually agrees on a means to figure out a way to settle the ambiguity. If we can have a real and actual diagnosis, then perhaps insurance will *have* to pay for the care and (not)feeding of those of us who need GLP-1s to live.
I am *just* at 24.7 BMI. 25 BMI is overweight. Now, I have never had a goal weight or BMI goal. It is just a coincidence that my BMI is where it is as I have stopped losing weight and settled at 130-134 lbs. Yes, the BMI chart is ridiculous!!!