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Body roundness not BMI?
For decades, the body mass index
(BMI) has been used by physicians
as a quick and simple way to assess
whether a patient's weight presents
a health risk for this purpose,
with calculations based on height
and weight. However, despite
its convenience, BMI has faced
increasing criticism, and recent
research suggests that the body
roundness index (BRI), might be
a better gauge of the health risks
associated with obesity.
BMI has always been a very crude
measure to characterize disease
risks. For example, BMI incorrectly
classifies individuals with significant
muscle mass, like bodybuilders,
as obese, as it doesn't distinguish
between fat and muscle mass. It also
provides no information about fat
distribution in the body - whether
it's concentrated in the hips or the
abdomen, for example. This means
that a person with a normal BMI
could already have prediabetes, high
blood pressure, and high cholesterol,
which might go undetected if no
further investigations are conducted,
based solely on their BMI.
According to experts, BRI may
more accurately identify people with
high levels of visceral fat than BMI:
it's well documented that abdominal
fat is strongly linked to higher risks
for obesity-related diseases. As its
name suggests, this index seeks to
capture a person's 'roundness'. The
formula for calculating BRI includes
waist circumference and height but
excludes body weight.
However, opinions differ on
whether the BRI should replace the
BMI. While some are optimistic about
the BRI's future, others point out
that since an entire medical system
has been built around the BMI, this
cannot be changed overnight.
Read more, CLICK HERE.
Clinical obesity defined
An upcoming document by a Lancet
Commission of 56 of the world's
leading obesity experts will entirely
reframe obesity as a "condition of
excess adiposity" that constitutes
a disease called "clinical obesity"
when related tissue and organ
abnormalities are present.
On November 4, the publication's
lead author, Francesco Rubino, MD,
chair of bariatric and metabolic
surgery at King's College London,
United Kingdom, noted that, despite
the declaration of obesity as a
chronic disease more than a decade
ago, the concept is still debated and
not widely accepted by the public nor
by all in the medical community.
"The idea of obesity as a disease
remains highly controversial," Rubino
noted, since the current body mass
index (BMI)-based definition doesn't
distinguish between currently healthy
people whose excess adiposity place
them at excess risk for disease vs those
who already have undergone bodily
harm from that adiposity. "Having a
framework that distinguishes at an
individual level when you are in a
condition of risk and when you have a
condition of disease is fundamentally
important" he noted.
The new paper will therefore
propose a two-part clinical approach:
First, assess whether the patient
has excess adiposity. Next, assess
on an organ-by-organ basis for the
presence of abnormalities related to
excess adiposity, or "clinical obesity."
Rubino told Medscape Medical
News he hopes the new framework
will prompt improvements in
reimbursement and public policy.
"Having an obesity definition that
is blurry doesn't allow you to have
a fair, human, and meaningful
prioritization… Now that we have
drugs that cannot be given to 100%
of people, how do you decide who
gets them first? I hope this will
make it easier for people to access
treatment."
Read more, CLICK HERE.