BMI is a measurement used widely to figure out if you are overweight. It looks at gender, height, and weight and then tells you if you are “underweight,” “normal,” or “overweight,” up to obesity. It is a useful tool, for all of its drawbacks, and it does correlate to health, surgical risk, and more. But is there a better way?
If you read our blog, you may remember a blog about body roundness index, which alludes to health having to do with where you put on weight. There is a correlation with waistlines being bigger to metabolic diseases.
This is a new report out of the Lancet Diabetes and Endocrinology Journal, January 2025. The gist is that focusing on your percentage of body fat and medical issues is important – not just the weight. This new definition of obesity was endorsed by 76 organizations around the world.
So what is the skinny on this new guideline?
“Definition and Diagnostic Criteria of Clinical Obesity.” The commission was made of 58 experts of different specialties from all over the world. They wanted to think of obesity in a different way. What is a “bad” weight? What is “ideal”? They thought of clinical obesity more like a chronic disease. They define obesity as a condition characterized by excess adiposity (fat), with or without abnormal distribution or function of adipose tissue. They acknowledge obesity is a chronic, systemic illness, which is multifactorial.
What is not up to debate is that obesity is bad. It increases organ damage – heart attacks, strokes, kidney failure. Preclinical obesity is seen when you have excess fat but your organs are still functioning.
So how do you find out how much fat?
- Directly measuring body fat – you see this in InBody scans (which we have at Biohackr), DEXA scans.
- Body Roundness Index. This simply measures your waist circumference, waist to hip ratio, or waist to height ratio.
- Waist circumference over 102 cm (40 inches) for men, 88 cm (34.6 inches) for women
- Waist to hip ratio of > 0.90 for men
- Waist to hip ratio of > 0.85 for women
- Waist to height ratio of >0.50 for all
- BMI over 40 does not need these other measures – no further confirmation is needed
Using this new method, someone with a BMI of 28 would prior be listed as “overweight.” But now if assessed and they have excess body fat, they are labeled as “preclinical obesity” if no organ issues, or “obese” if organ issues. Conversely, someone with a BMI of 30 is labeled as “obese.” But when evaluated now, if they have no excess fat or signs and symptoms of obesity, these patients have high muscles mass (athletes) – they are not obese, as they have normal fat mass – so there is no label of obesity.
If you have obesity as defined by EXCESS BODY FAT, then you are deeply assessed – medical history, physical exam, and blood tests. Are there any signs of organ issues? (blood pressure, heart disease, diabetes) Are there any limitations to your daily activities? If you have any issues of organ function, you are preclinical obesity. If you have limitations in activities, you are obese.
CLINICAL OBESITY becomes those with:
- Organ or tissue failure
- Substantial age-adjusted limitations to activities of daily life – bathing, dressing, toilet, continence, eating. They may get breathless easily, have knee and hip pain, joint stiffness, reduced range of motion, metabolic issues, and airway/kidney/urine/nerve/reproductive issues.
- Preclinical obesity are people with excess fat, but no organ damage evident yet. They should be counseled, monitored, and do interventions to reduce the risk of clinical obesity. They are at a high risk of developing clinical obesity, heart disease, cancer, and Type 2 diabetes.
How can Biohackr Health help?
- Figure out your muscle vs. fat percentage with an InBody Scan
- Look at your body roundness index
- TEST. See if you have any issues with blood sugar, cholesterol, and other issues. If at heart risk, do a cardiac calcium scan. If at diabetes risk, do a continuous glucose monitor.
- BUILD MUSCLE. Do creatine (which you can buy our Biohackr brand, high-quality, German-made creatine monophosphate) paired with resistance training.
- LOSE WEIGHT. Need help? Our probiotic helps with glucose control. NAD+. Semaglutide and Tirzepatide. Get a consultation with our doctor to see what you can do.
- EDUCATE. These blogs are all about bringing science to you. Healthspan and aging better is what we focus on at Biohackr Health. New studies come out daily. Keep up to date.
