New Delhi: There is nothing new about the body mass index or BMI as it has been around for several years. This numerical value assists in determining whether a person is obese, overweight, or underweight. However, it turns out that those criteria have been out of date for quite some time now, since 1832. As reported by the Lancet, the definition of obesity, currently in use, has been contributing to the increasing incidence of arthritis, diabetes and other metabolic and physical health problems associated with a high body mass index. To date, excessive fat was always termed as 30+ BMI which is the standard measure for severe obesity. But, as mentioned above, a new set of criteria will be issued in the next 15 years which will, however, include waist circumference as a factor.

In India, abdominal obesity has until now been widespread but it does tend to get overlooked due to the age-old BMI standards. But now, specialists want to merge BMI with other aspects such as waist size and even a direct bodys composition analysis for more accurate results. But now, obesity has been classified into two types:

Clinical obesity has straightforward consequences and requires medical care

Pre-clinical obesity in which problems are not severe and showing up to counseling might be enough.

This new methodology will help assess the possibilities of such risks ever occurring and even go as far as to avert such risks from developing in the first place – heart problem as an example.

Why is BMI misleading?

While differentiating obesity in general and obesity as described in the report by The lancet, Dr Misra remarked, “Indians may not have too much weight but have higher body fat, and this we realised in the year 2000. They also have wider waist which shows that most of their body fat distribution is in the trunk. In 2009, we started looking at Indians with 30 BMI as our definition of obesity. What explains this lower limit, is because people started having health problems like diabetes as lower whether it is BMI or 30. So that continued till now, but in the meantime there were plenty of studies that clearly showed that BMI is a false indicator.”

“Therefore, actually, the body fat is the best indicator of obesity. But this is difficult to evaluate because it requires an expensive apparatus. But it can be found elsewhere. Clinically, too, waist circumference as abdominal fat indicator is also needed. But along with obesity many health problems should also be considered like hypertension and type 2 diabetes mellitus. But if a person has obesity related problems on the bones and which affects movement then that also needs to be factored in.”

This is indeed a better definition of obesity, as it also helps one understand how best to treat or rehabilitate a patient. .” Dr Misra acknowledged.

The specialist also remarked that India’s stage 1 obesity encompasses all complications which to him are minor. While stage 2 obesity bares consequences that I consider to be pertinent.

Why is it more prominent in Asian Indians?

Dr Misra noted that this has not happened overnight. It is something that has been worked on for over 10 years actually. The most problematic fat, as per the expert, is the one that sits right beneath the upper layer of skin. It is most problematic and is known as subcutaneous fat and this is what generates inflammation. This fat is found predominantly in the Indian population than the Western population. Liver fat, too, along with subcutaneous fat, generates a lot of inflammation which can lead to diabetes, high cholesterol, BP problems, and heart diseases.