BMI does not exactly measure total body fat content, finds study

Is obesity related to BMI alone? No, say experts who co-wrote a research paper which recently got published in the journal JAPI (Journal of Association of Physicians of India) this year. 

In the paper titled ‘Consensus on Current Landscape and Treatment Trends of Obesity in India for Primary Care Physicians’, the authors argue that “Body Mass Index and waist circumference were both recommended for better identification of people at risk of obesity-related comorbidities than either of them alone.” Additionally, the paper argued that the diagnosis and management of obesity should be comprehensive and consider patient psychology as well. Researchers noted that obesity is increasing in prevalence in India and is projected to rise in the coming years. 

 The most significant takeaway from the paper is that although Body Mass Index (BMI) assessment is one of the most common measures of obesity, it does not exactly measure/ correlate with the total content of body fat; this is because the total content of body fat in two individuals having the same BMI could differ by a factor of two, notes the paper.

Assessments of the usefulness of BMI in detecting body adiposity indicate that although BMI cut-off values have high specificity, they lack sensitivity in identifying adiposity (percentage body fat). Also, BMI evaluation is insufficient for identifying individuals with excess body fat percentage in 50 per cent of the cases. The study also noted that BMI assessment alone does not adequately predict associated comorbidities or disease risk, and changes in BMI do not adequately indicate improvements in overall wellness. 

 “Body mass index (BMI) is the common measure used to define obesity. According to the guidelines, in India, a person is considered overweight when their BMI is between 23-25 kg/m2, while a person with a BMI over 25 kg/m2 is considered obese. The Indian population is prone to developing excess fat accumulation around the waist, especially around the internal organs such as the liver and the pancreas. This can be the starting point for metabolic diseases such as diabetes, also known as visceral obesity or abdominal obesity. Unfortunately, the Indian population that has abdominal obesity and metabolic syndrome is at a higher risk for cardiovascular disease, irrespective of their body mass index,” explained Dr Shah. 

 In a press conference held recently in this regard, the use of once-a-week semaglutide (2.4 mg) via the subcutaneous route was suggested as the first-choice anti-obesity treatment. Obesity is the accumulation of excess body fat to the extent that it presents a health risk. At the conference, experts including Dr. Shashank Shah, Bariatric Surgeon, along with Dr Neeta Deshpande, endocrinologist and obesity physician, shared a nationwide cross-sectional study in which they said, surveyed 531 adults in a randomized cluster sample across India. The results showed that the prevalence of obesity in the country is 40.3 pc, with a higher incidence among women, urban populations, and individuals aged over 40 years. The highest incidence was reported in South India (46.51 pc) while the lowest was in East India (32.96 pc). It has been predicted that the prevalence of obesity will triple by 2040 among Indian adults aged 20 to 69 years. 

 “At the international level, these new guidelines have already been implemented and treatment of obesity is based on associated problems. India is known as the capital of diabetes, and it is one of the youngest nations in the world. Obesity and overweight have reached pandemic proportions across the globe today, and India is no exception. This condition is the mother of all metabolic diseases, including cancer, type 2 diabetes, hypertension, etc., and mechanical disorders such as arthritis of the knees, not to mention mental disorders such as anxiety and depression. The economic burden to the individual, community, and the country can be enormous,” said Dr Shah.