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Experts Call for Overhaul in Obesity Diagnosis Amid Criticism of BMI Reliance

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4 months ago

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Global health experts have called for a fundamental reevaluation of how obesity is diagnosed, urging a shift from the long-standing reliance on body mass index (BMI) to a more nuanced and individualized approach. The recommendations come from a panel of 56 specialists and patients, who published their findings in The Lancet Diabetes & Endocrinology.

A Complex Condition

Obesity, affecting roughly one in eight people worldwide, is a risk factor for numerous health conditions, including type 2 diabetes, cardiovascular disease, and certain cancers. However, experts argue that it is not always synonymous with ill health. The commission has proposed distinguishing between clinical obesity, a chronic disease marked by organ dysfunction or physical limitations caused by excess fat, and preclinical obesity, where individuals have obesity but maintain normal organ function.

“There are some people who have obesity and manage to live a relatively normal life … and on the other hand, you have [people] who may suffer significant health issues due to obesity alone,” said Dr. Francesco Rubino, the commission’s chair and a professor at King’s College London.

BMI Under Fire

BMI, a measure derived from a person’s weight and height, has been the primary diagnostic tool for obesity since the World Health Organization adopted it in the 1990s. A BMI of 30 or higher classifies an adult as obese. While BMI offers a simple proxy for body fat and related health risks, critics say it is flawed and outdated.

“It’s not just how much fat you have, it’s also where the fat is that’s important,” said Dr. Adam Collins, a nutrition expert at the University of Surrey. He highlighted that BMI does not account for fat distribution or differentiate between fat and muscle mass, leading to potential misclassifications.

Athletes with high muscle mass, for example, may fall into the obese category despite being in excellent health.

A New Framework

The commission has recommended that BMI remain a preliminary screening tool but that an official diagnosis of clinical obesity should involve more comprehensive criteria. These include signs such as obesity-induced breathlessness, heart failure, and joint pain, among others.

Adopting this approach could reduce overdiagnosis and ensure medical care is tailored to an individual’s health needs rather than focusing solely on weight loss. This shift is especially crucial as governments debate how to allocate resources, such as expensive weight-loss drugs like Wegovy and Mounjaro, which are in limited supply.

Changing Perspectives

Beyond medical practice, experts hope the new framework will combat the stigma around obesity and promote better understanding of metabolic health for people of all sizes. “This leads to a change in practice and, maybe even before that, a change in mindsets,” Rubino said.

Though it may take time to implement these changes, advocates believe this step could reshape how obesity is perceived and treated globally.

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UK Scientists Develop Tool to Measure ‘Heart Age,’ Offering New Insights for Cardiovascular Health

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3 days ago

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May 6, 2025

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Researchers in the United Kingdom have developed a new tool that can determine how old a person’s heart is in comparison to their actual age, offering a potential breakthrough in the early detection and prevention of cardiovascular disease.

The study, led by scientists at the University of East Anglia (UEA), examined magnetic resonance imaging (MRI) scans from 557 individuals across the UK, Spain, and Singapore. Of those, 336 participants had known health risk factors such as obesity, high blood pressure, or diabetes.

Using these scans, the researchers measured structural and functional markers of cardiac health — including the size of the heart’s chambers and how effectively it pumps blood. These indicators were then used to create an algorithm that calculates the heart’s “functional age.”

The findings, published in the European Heart Journal, revealed that individuals with cardiovascular risk factors had hearts that were, on average, 4.6 years older than their chronological age. In people with obesity, the gap was even wider, indicating faster cardiac ageing.

“People with health issues like diabetes or obesity often have hearts that are ageing faster than they should – sometimes by decades,” said Dr. Pankaj Garg, a cardiologist and lead author of the study. “This tool gives us a way to visualize and quantify that risk.”

While the tool shows promise, researchers noted some limitations. The model does not account for how long patients had lived with their conditions, and the study group primarily included older individuals who had survived with these health issues — raising concerns about survivor bias. The relatively small sample size also means the tool needs broader validation before it can be widely adopted.

Despite these limitations, the research team believes the tool could have valuable clinical applications in the future. Dr. Garg said it may help doctors counsel patients more effectively about their cardiovascular health and recommend lifestyle changes or treatments to slow heart ageing.

“By knowing your heart’s true age, patients could get advice or treatments to slow down the ageing process, potentially preventing heart attacks or strokes,” he said. “It’s about giving people a fighting chance against heart disease.”

The team hopes the tool could eventually be integrated into routine care, empowering patients to take early steps toward improving their heart health through diet, exercise, and medical intervention.

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Global Health Inequities Persist as Progress on Life Expectancy and Mortality Slows, Says WHO

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3 days ago

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May 6, 2025

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While the world has made significant strides in narrowing health disparities between rich and poor nations over the past two decades, progress is now faltering — and in some cases reversing — according to a new report by the World Health Organization (WHO).

The report, the WHO’s first comprehensive analysis on health equity since 2008, finds that although gaps in life expectancy, child mortality, and maternal health have narrowed globally, none of the agency’s long-term health targets for 2040 are currently on track to be met.

“There has been some progress narrowing health gaps between countries, but it is stalling,” said Dr. Sudhvir Singh, who leads the WHO’s equity and health unit, during a press briefing. He called for urgent action to address the underlying social, political, and economic factors driving health inequalities.

The WHO’s 2040 targets include halving the gap in life expectancy between countries, reducing adult mortality by half, slashing child deaths under age five by 90 percent, and cutting maternal mortality by 95 percent. Yet, the latest figures reveal that progress toward these goals has slowed dramatically.

A stark example is life expectancy. While people in high-income countries such as Japan enjoy an average lifespan of 84.5 years, those in countries like Lesotho live on average only 51.5 years — a gap of 33 years. The global average gap still stands at 12.5 years, well short of the WHO’s goal to reduce it to 8.2 years by 2040.

Child mortality has improved significantly, with global rates dropping from 77 deaths per 1,000 live births in 2000 to 37 in 2023. But children in low-income nations remain 13 times more likely to die before age five compared to those in wealthier countries. The WHO’s target of eight deaths per 1,000 by 2040 appears increasingly out of reach.

Maternal mortality has declined by 40 percent since 2000, yet the current global rate remains at 197 deaths per 100,000 live births — more than twelve times higher than the 2040 goal of just 16.

The report also highlights major disparities within countries. Poorer communities, women, ethnic minorities, and other marginalized groups continue to face worse health outcomes due to factors such as income inequality, poor access to public services, systemic discrimination, and environmental threats like climate change.

WHO officials warned that climate change alone could push up to 135 million people into extreme poverty in the next five years — further widening health gaps unless governments act decisively.

“There’s a very positive return on investment from addressing these social determinants of health,” said Singh. “And there’s a huge cost of inaction.”

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Measles Surges Across Europe as Health Authorities Sound the Alarm

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5 days ago

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May 4, 2025

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Measles, one of the world’s most contagious diseases, is spreading rapidly across Europe, with health officials warning of continued outbreaks in the coming months. According to the European Centre for Disease Prevention and Control (ECDC), over 4,500 cases have been reported across the European Union so far this year, with Romania experiencing the most severe impact.

Romania has recorded 3,203 measles cases through the end of March, making it the epicentre of the EU’s measles crisis. Four people have died, the only reported measles-related fatalities in the bloc this year. Experts attribute the surge in Romania to persistent vaccine hesitancy, misinformation, and a strained healthcare system. The country’s measles vaccination rate stood at just 62% in 2023—well below the 95% threshold needed to achieve herd immunity and prevent outbreaks.

France has reported 345 measles cases this year, with authorities noting a significant number of infections linked to international travel, particularly from Morocco. At least 41 cases were directly tied to imported infections. Although France had a relatively high vaccination rate of 93% in 2023, unvaccinated clusters remain vulnerable to outbreaks.

Italy, with 227 cases so far in 2025, ranks just behind France in the number of infections reported outside Romania. The country’s vaccination coverage—85% in 2023—also falls short of the level needed to prevent the disease from spreading.

In the Netherlands, 204 cases have been recorded in the first quarter of the year, many stemming from travelers arriving from Morocco and Romania. Dutch health authorities reported localized clusters, particularly in primary schools and childcare facilities. Despite no national outbreak being declared, the country’s vaccination rate of 81% remains one of the lowest in the EU.

Spain has reported 202 measles infections in 2025, with several localized outbreaks and a number of imported cases. The country’s 92% vaccination coverage places it near herd immunity, but health officials caution that gaps in immunization still leave room for outbreaks, especially when cases are introduced from abroad.

Health experts across Europe are urging parents to ensure their children are fully vaccinated, emphasizing that the measles vaccine is both safe and effective. The ECDC continues to monitor the situation and warns that without improved vaccination coverage, the risk of further outbreaks remains high.

Last year was the worst for measles in Europe and Central Asia since 1997, with over 120,000 cases. Authorities fear 2025 could follow a similar trajectory if vaccination rates do not improve.

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