Scientists Suggest New Way to Help Measure Obesity Instead of Just Using Traditional BMI Metric

An international committee of scientists has proposed a new way to determine excess body fat instead of just relying 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, Jan. 14.

The report’s findings suggest that BMI — the measurement traditionally used by medical professionals to determine healthy weight ranges — does not provide a nuanced enough assessment of health as it relates to weight.

The Lancet report suggests that another metric is far more useful when determining a patient’s overall health: the amount of belly fat they have.

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The report’s authors note that attaining this information can be done in multiple ways, including measuring a person's waist, waist-to-hip ratio or waist-to-height ratio. There are also scans that exist that can determine the precise amount of excess belly fat on a patient.

Meanwhile, BMI is calculated by using only 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 might score in the “obese” BMI range. And a person with a “healthy” BMI might have excess fat around their internal organs.

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While speaking to NPR, Dr. Robert Kushner, an endocrinologist at Northwestern University who is a part of the commission, noted that belly fat specifically puts patients at risk for a number of health issues.

"Fat in the belly causes systemic inflammation, which then goes on and causes other metabolic problems like elevated blood sugar, elevated blood pressure and increased fats in the blood," he told the outlet. “This can set the stage for metabolic diseases including diabetes as well as heart disease.”

Kushner also said that the commission does not recommend doing away with BMI entirely but stressed the importance of also using this other important metric in order 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 commission — said that the goal of the new report is “to get a more precise definition [of obesity] so that we are targeting the people who actually need the help most.”

The report also recommended that medical professionals begin using two distinct diagnostic categories when it comes to obesity: clinical obesity and pre-clinical obesity.

Patients defined as clinically obese would be defined as those who exhibit excess body fat while also showing signs of weight-related health issues like heart disease, high blood pressure and chronic joint pain. People with pre-clinical obesity would be defined as those who carry excess weight but do not yet exhibit the chronic health conditions typically associated with it.

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