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BMI alone not sufficient, waist-to-height ratio more effective in diagnosing obesity

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New obesity diagnosis goes beyond BMI! Researchers propose including waist-to-height ratio to identify high health risks from fat distribution.

Researchers have introduced a new framework for diagnosing and managing obesity, stating that it should no longer be defined solely by body mass index (BMI), but rather by the distribution of body fat throughout an individual’s body.

Published in Nature Medicine, the study examines abdominal fat measured by waist-to-height ratio. Researchers found that a higher ratio is linked to an increased risk of cardiometabolic complications, highlighting the significance of abdominal fat in health assessments.

The authors from the European Association for the Study of Obesity (EASO) highlighted a significant innovation in the framework: diagnosing obesity now includes a waist-to-height ratio over 0.5, along with a BMI between 25 and 30.

“The choice of introducing waist-to-height ratio, instead of waist circumference, in the diagnostic process is due to its superiority as a cardiometabolic disease risk marker,” they wrote.

Accumulation of abdominal fat is a more reliable predictor of health deterioration, compared to BMI, even for individuals not meeting the current standard cut-off value for obesity diagnosis, which is a BMI of 30, the authors said.

They said that the current guidelines are based on evidence from studies in which participants meeting cut-off values were included for analysis, rather than on a “complete clinical evaluation”.

“The basis for this change is the recognition that BMI alone is insufficient as a diagnostic criterion, and that body fat distribution has a substantial effect on health,” they wrote.

The researchers proposed that modifying diagnostic methods could lower the risk of undertreating patients with low BMI and high abdominal fat, as the current BMI-based obesity definition might not adequately address the needs of this specific group.


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