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A better definition of obesity

New guidelines use more than just body mass index to diagnose obesity

• Link to: Northwestern Now Story

• Northwestern obesity expert is a commissioner on new international guidelines released today
• Two new diagnostic categories of obesity introduced: clinical and pre-clinical obesity
• New guidance says health insurance should cover clinical obesity without presence of another disease
• Media can attend virtual global launch of the commission on Jan. 16, 8 a.m.- noon (ET)

CHICAGO --- The clinical definition for "obesity" is not one size fits all. Relying on body mass index (BMI) alone can lead to under-diagnosis of people who are ill and, conversely, over-diagnosis of people who currently do not have negative health consequences of obesity.

A new set of global clinical guidelines released today (Jan. 14) aims to address that.

With one billion people in the world now estimated to be living with obesity, The Lancet Diabetes & Endocrinology Commission - which is endorsed by 75 medical organizations around the world - has set out a new way to diagnose obesity to use objective measures of illness based on an individual's risk factors. This is a significant shift from the current standard of care, which primarily relies on BMI to diagnose obesity.

The commission also has introduced two novel diagnostic categories of obesity: clinical obesity and pre-clinical obesity, which delineate if and how an individual's excess body fat affects their organ health and daily functioning.

Northwestern Medicine obesity expert Dr. Robert Kushner is a member of the commission that devised the new definition and diagnostic criteria of clinical obesity.

"The commission's report is a major step forward in recognizing obesity as a disease and not merely a risk factor. It also helps clinicians identify individuals who are in need of treatment," said Kushner, a professor of medicine (endocrinology and medical education) at Northwestern University Feinberg School of Medicine.

Kushner is available to speak to media starting Jan. 20. Contact Kristin Samuelson at [email protected] to arrange an interview.

Media are invited to attend the virtual global launch of the commission on Thursday, Jan. 16, from 8 a.m. to noon. (ET). Media can register to watch the livestream here.

Kushner can speak to media about the following:

• How current measures of obesity do not allow accurate disease diagnosis and hinder care and policy around obesity
• The thought process and research behind the new guidelines
• Who is likely to benefit from having a new, universal clinical definition of obesity
• How and when BMI should be used effectively in the diagnosis and treatment of obesity
• What these guidelines mean for the use of the new highly effective drugs for treating obesity
• The likelihood that health care providers and health insurance companies could be influenced by the guidelines

Other key details from the new guidelines

• Clinical obesity is defined in the new guidelines as a chronic disease with specific signs and symptoms of ongoing organ dysfunction due to obesity alone. Treatment for clinical obesity - lifestyle, medication, surgery, etc. - should be aimed to fully regain or improve the body functions reduced by excess body fat.
• Pre-clinical obesity is defined in the new guidelines as being associated with variable level of health risk, but no ongoing health complications due to excess body fat. The approach to care should aim at risk reduction.
• All people living with obesity should receive health advice and evidence-based care when needed - free of stigma and blame - with different strategies for clinical obesity and pre-clinical obesity.
• As a distinct chronic illness, clinical obesity should not necessitate the presence of another disease (e.g. Type 2 diabetes) to justify health insurance coverage.