Obesity Measurement Inaccuracies Raise Questions About IndiaS Prevalence Rates, Treatment Needs
New Delhi – Current methods of measuring obesity, primarily relying on Body Mass Index (BMI), may significantly underestimate the prevalence of the condition, notably in populations like India, according to a growing body of research and expert opinion. This miscalculation impacts screening efforts and perhaps delays necessary medical intervention for a considerable number of individuals.
BMI, a calculation based on height and weight, was originally developed using measurements from Caucasian populations and doesn’t account for factors like race, age, sex, or body composition. While a BMI over 40 kg/m² is generally considered a clear indicator of excess adiposity, the metric’s limitations are becoming increasingly apparent. Studies show that BMI often fails to accurately reflect body fat levels; one study found that while BMI categorized only 26% of subjects as obese, DXA scans – a more precise measurement – identified 64% as obese. Furthermore,BMI has been shown to misclassify more women than men.
the National Family Health Survey estimates that one in four Indians – approximately 135 million people – are obese, a figure based on BMI guidelines.Though, experts now suggest this number might potentially be a critically important undercount. South asians, in particular, tend to have higher levels of body fat even with normal bmis.
“Current epidemiological data on obesity prevalence, which rely solely on BMI, must be updated to reflect obesity as a spectrum of medical presentations,” states a recent report from an unnamed Commission. Preliminary audits of existing databases suggest a “substantial number of people with obesity do not fulfil the criteria for clinical obesity” when assessed beyond BMI.
More accurate assessments can be achieved through methods like Dual X-ray Absorptiometry (DXA), but these are expensive and not widely available. The Lancet Commission recommends incorporating measurements like waist circumference, waist-to-hip ratio, and waist-to-height ratio alongside BMI for a more extensive evaluation.
The complexity of obesity is further highlighted by examples like sumo wrestlers, who can maintain high levels of fitness despite high BMIs and large body sizes. Experts emphasize the need for individualized clinical assessments to determine the appropriate course of action,rather than relying solely on BMI as a diagnostic tool.
