Health
Experts Call for Overhaul in Obesity Diagnosis Amid Criticism of BMI Reliance
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 While BMI offers a simple proxy for body fat and related health risks, critics say it is flawed and outdated.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.
Health
Global Mental Health Cases Near 1.2 Billion as Anxiety and Depression Drive Sharp Worldwide Rise
A major global analysis has found that mental health conditions have surged to an estimated 1.2 billion people worldwide, driven largely by steep increases in anxiety and depression over the past three decades.
The findings, published in The Lancet as part of the Global Burden of Disease Study 2023, show that the number of people living with mental disorders has almost doubled since 1990, marking a 95% rise. Researchers say major depressive disorder and anxiety disorders have seen even sharper growth, increasing by 131% and 158% respectively, making them the most prevalent mental health conditions globally.
The report describes mental illnesses as widespread conditions that create long-term disability and significant human suffering. It also highlights broader consequences for economies and public services, including reduced productivity, lower workforce participation and increasing pressure on health and welfare systems.
Researchers estimate that in 2023 alone, around 620 million females and 552 million males were affected by mental health conditions. While the overall burden is rising across both sexes, the study points to notable differences in the types and prevalence of disorders.
Among women, depression and anxiety were the most commonly reported conditions, alongside higher rates of eating disorders such as anorexia nervosa and bulimia nervosa. The report links this disparity to a mix of biological, social and structural factors, including exposure to domestic violence, sexual abuse, gender inequality and reproductive health-related changes.
In contrast, neurodevelopmental and behavioural disorders, including attention deficit hyperactivity disorder (ADHD), conduct disorder and autism spectrum conditions, were more frequently diagnosed in men.
Teenagers aged 15 to 19 were identified as the group experiencing the highest mental health burden globally, raising concerns about early onset of conditions and insufficient preventive care for young people.
The study identifies several key risk factors associated with mental illness, including childhood sexual violence, bullying and intimate partner violence. These factors are strongly linked to conditions such as depression, schizophrenia, bipolar disorder and anxiety disorders. However, researchers note that such exposures have remained relatively stable over time and account for only a portion of the overall rise.
According to the authors, broader drivers are likely contributing to the increasing prevalence of mental disorders. These include genetic and biological influences, poverty, inequality, and the growing impact of global crises such as armed conflict, pandemics, natural disasters and climate-related stress.
While mental health conditions have long been a leading cause of disability worldwide, the report warns that the situation is worsening. At the same time, health systems have not expanded services at a pace matching demand.
The authors caution that the gap between rising need and limited access to care is becoming more pronounced, leaving millions without adequate treatment or support.
Health
Europe Records Sharp Rise in Sexually Transmitted Infections, ECDC Warns
Health
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