Latest research: Obesity diagnosis cannot be based solely on weight, BMI has natural flaws

Based on data from more than 840,000 people in four countries including China, the United Kingdom, the United States, and Spain, a Chinese and foreign research team confirmed that obesity diagnosis cannot be based solely on weight, let alone BMI (weight divided by height squared). The relevant results were published in the international journal Nature in the early morning of the 12th, Beijing time.

For a long time, BMI has been widely used around the world as the core indicator for screening and determining obesity. However, Pan An, the first author and co-corresponding author of the paper and a professor at the School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, pointed out that BMI has a natural flaw – it can only calculate the relationship between weight and height, but cannot distinguish whether the increase is muscle or fat, let alone whether the accumulated fat has damaged internal organs.

In this study, Pan An’s team and collaborators studied cross-national data of more than 840,000 people and found that 5.2%-8.6% of participants’ obesity was underestimated by BMI, and 1.2%-3.1% was overestimated. Among those with excess body fat, only 22.7% to 31.3% have impaired organ function or limited body function due to obesity (“clinical obesity”), and the vast majority are still in the “preclinical obesity” stage where the organs and body functions are not damaged by obesity.

During more than 10 years of follow-up, the research team also found that compared with healthy people, people in the “preclinical obesity” stage had a 19% increased risk of all-cause death. Once they worsened to “clinical obesity,” the risk of death increased sharply to 69%. In addition, about 77% to 91% of people with “preclinical obesity” have not progressed to “clinical obesity”, which means that as long as timely scientific intervention and lifestyle modification are carried out in the early and middle stages when the organs are not damaged, the vast majority of people are expected to maintain their bottom line of health and block the progression of the disease.

Pan An pointed out that this result provides data support for global health policy and medical resource allocation. In the context of the rapid development of new weight loss drugs, identifying who needs resource intervention more is the core of decision-making. Drawing clear risk boundaries can not only prevent excessive consumption of resources, but also guide the transformation of the public health system from simply “controlling weight” to “maintaining healthy organ function.”

Original title: “Research by Chinese and foreign teams confirms: Obesity diagnosis cannot be based solely on weight”

Author: Huang Shuangzi Ma Furong