An international committee of scientists has proposed a new way to determine excess body fat instead of relying solely on body mass index (BMI).
More than 50 experts in fields such as nutrition, endocrinology and public health published their recommendations in the peer-reviewed journal The Lancet Diabetes & Endocrinology on Tuesday, January 14.
The report’s findings suggest that BMI – the measurement traditionally used by medical professionals to determine a healthy weight – does not provide a nuanced enough assessment of health when it comes to weight.
The Lancet report suggests that another metric is much more useful in determining a patient’s overall health: the amount of belly fat they have.
The report’s authors note that obtaining this information can be done in multiple ways, including measuring a person’s waist, waist-to-hip ratio, or waist-to-height ratio. Scans also exist that can determine the precise amount of excess abdominal fat in a patient.
Meanwhile, BMI is calculated by using just two sets of data points: a patient’s height and weight, according to the National Institutes of Health.
However, the new report notes that BMI can lead to both over- and under-reporting of obesity. An athlete with little body fat but significant muscle mass may score in the “obese” BMI range. And a person with a “healthy” BMI may have excess fat around their internal organs.
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During a conversation with NPR, Dr. Robert Kushner, an endocrinologist at Northwestern University who is part of the committee, notes that belly fat specifically puts patients at risk for a number of health problems.
“Fat in the abdomen causes systemic inflammation, which then progresses to cause other metabolic problems such as increased blood sugar, increased blood pressure and increased fats in the blood,” he told the paper. “This could pave the way for metabolic diseases, including diabetes, and heart disease.”
Kushner also said the committee does not recommend abolishing BMI entirely, but emphasized the importance of also using this other important metric to get a more accurate picture of a patient’s health.
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In a statement to PBS News, Dr. David Cummings – an obesity expert at the University of Washington and another researcher on the committee – that the aim of the new report is “to get a more precise definition [of obesity] so that we focus on the people who actually need the help the most.”
The report also recommends that medical professionals start using two different diagnostic categories when it comes to obesity: clinical obesity and preclinical obesity.
Patients defined as clinically obese are defined as those who exhibit excess body fat while simultaneously showing signs of weight-related health problems, such as heart disease, high blood pressure, and chronic joint pain. People with preclinical obesity would be defined as those who are overweight but do not yet exhibit the chronic health problems that typically accompany it.