Health
BMI is wrong way to measure obesity, researchers say — here’s what they recommend instead
A group of 58 researchers is calling for a new, better way to measure obesity.
The global team’s recommendations were published in The Lancet Diabetes & Endocrinology on Jan. 14.
Body mass index (BMI) has been the international standard for measuring obesity since the 1980s, according to many sources, though some experts have questioned its validity.
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A person’s BMI is calculated by dividing his or her weight by the square of his or her height in feet.
Body mass index (BMI) has been the international standard for measuring obesity since the 1980s, according to many sources, though some experts have questioned its validity. (iStock)
“Obesity is a complex problem and has different significance at the individual level,” the report’s lead author Francesco Rubino, chair of bariatric and metabolic surgery at King’s College London, United Kingdom, told Fox News Digital.
Obesity is a “spectrum,” he said, rather than a “single, distinct clinical entity.”
Rubino went on, “It is impossible to say if obesity is a disease or not, as disease status cannot coincide with body size or mere excess body fat.”
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The Commission on Clinical Obesity has proposed a “reframing” of obesity that distinguishes between people who have a disease here and now, and those who may have a risk for future disease, Rubino said.
Instead of relying solely on BMI, the researchers recommend also measuring adiposity, which is the amount of excess body fat.
A person’s BMI is calculated by dividing his or her weight by the square of his or her height in feet. (iStock)
Adiposity can be determined by measuring a person’s waist circumference or taking body scans to measure fat mass, according to the researchers.
The group of experts recommends using two levels of obesity: preclinical and clinical.
With preclinical obesity, the person has excess body fat that has not affected the function of their tissues and organs.
“People with clinical obesity suffer from a chronic illness and should be treated in the same way as people who suffer from any other chronic disease.”
The person may have, however, an increased risk of developing clinical obesity, type 2 diabetes, heart disease and some types of cancer, the researchers noted.
Clinical obesity is defined as “a chronic, systemic illness characterized by alterations in the function of tissues, organs, the entire individual or a combination thereof, due to excess adiposity.”
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With clinical obesity, the person may experience “severe end-organ damage, causing life-altering and potentially life-threatening complications,” the researchers wrote.
Potential effects of clinical obesity may include heart attack, stroke and kidney failure.
“As these categories of obesity are entirely new, we can’t measure their relative prevalence in the population,” Rubino noted. “Doctors have not yet had the possibility to make such a diagnosis, because many of the organ dysfunctions that characterize clinical obesity have not been routinely assessed so far.”
When excess body fat is confirmed, clinicians should assess individuals to determine whether obesity may have caused any organ dysfunction, the study researcher said. (iStock)
The researchers call for future studies into these diagnoses.
“We recommend that clinicians thoroughly assess people with obesity in the clinic and use other measures of body size — waist circumference or others — to understand if an increased BMI level is due to excess body fat or other reasons, like increased muscle mass,” Rubino told Fox News Digital.
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When excess body fat — meaning obesity — is confirmed, clinicians should assess individuals to determine whether obesity may have caused any organ dysfunction, the researcher said.
“People with clinical obesity suffer from a chronic illness and should be treated in the same way as people who suffer from any other chronic disease,” Rubino said.
People with preclinical obesity should undergo “evidence-based health counseling, monitoring of their health status over time, and, when applicable, appropriate intervention to reduce risk of developing clinical obesity,” they wrote.
Between August 2021 and August 2023, approximately 40% of U.S. adults had obesity, according to the Centers for Disease Control and Prevention (CDC). Around 9.4% of those adults had severe obesity.
‘Outdated measure’
Dr. Brett Osborn, a neurosurgeon, longevity expert and fitness competitor based in Florida, agrees that BMI is an “outdated measure” for diagnosing obesity.
“It is clear that obesity should no longer be defined solely by physical appearance or weight.”
“As medicine evolves, it is clear that obesity should no longer be defined solely by physical appearance or weight — or weight relative to height, as in BMI calculations,” the doctor, who was not involved in this new research, told Fox News Digital.
“Instead, the condition must be understood through the lens of metabolic dysfunction.”
Obesity isn’t just a disease of excess weight, Osborn said, but a “systemic metabolic disorder requiring nuanced and individualized care.”
The condition is better measured by looking at factors like inflammation, insulin resistance and glucose tolerance, according to the doctor.
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In some cases, using BMI can result in “muscular athletes” being labeled as obese, he noted, and people with “normal” BMI can sometimes have “harmful” levels of visceral (abdominal) fat.
Osborn noted that in his own clinic, he and his team do not use BMI, relying instead on visceral fat scores, skeletal muscle mass and body fat percentage.
In some cases, using BMI can result in “muscular athletes” being labeled as obese, one doctor noted. (iStock)
Skeletal muscle mass (the muscles that connect to the bones) is critical to physical strength and metabolic efficiency, Osborn said.
For optimal health, he recommends that males aim for 50% skeletal muscle mass relative to total body weight and females target 45% — although other factors, like age and fitness levels, come into play.
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“Remember, your resilience — your ability to ward off disease — resides in your muscle,” Osborn added.
“By integrating body composition metrics, metabolic markers and personalized assessments, we can more accurately diagnose obesity and tailor interventions to each individual.”
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Amid warnings of a Legionnaires’ disease outbreak on Manhattan’s Upper East Side, health experts say that early recognition of symptoms can mean the difference between a quick recovery and life-threatening complications, especially for high-risk groups.
New York City health officials are urging anyone who has visited the east side of Central Park or Manhattan’s Upper East Side since late June to watch for symptoms.
As of July 6, the New York City Health Department had confirmed 23 cases and 17 hospitalizations associated with the respiratory infection. No deaths have been reported.
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Officials are investigating contaminated cooling towers as the likely source. They have emphasized that the illness is not spread person-to-person and is not linked to the city’s drinking water.
Health experts say that early recognition of symptoms can mean the difference between a quick recovery and life-threatening complications, especially for high-risk groups. (iStock)
“Legionnaires’ disease is deadly but can be effectively treated if diagnosed early,” said NYC Health Commissioner Dr. Alister Martin in a press release. “New Yorkers at higher risk, including anyone who is 50 and older, those who smoke or people with chronic lung conditions should be especially mindful of their symptoms and seek care as soon as symptoms begin.”
What is Legionnaires’?
Legionnaires’ disease is a type of pneumonia caused by Legionella bacteria.
The bacteria is usually found in lakes, streams and other freshwater environments, but can grow in any area where water sits for a long time, according to the CDC.
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That can include shower heads, sink faucets, hot tubs, water features/fountains, plumbing systems and other water systems.
When people swallow or breathe in droplets of water that contain Legionella, they can potentially become ill.
Although human transmission is possible in rare cases, the disease is not typically transmitted among people, per the Centers for Disease Control and Prevention.
Symptoms of infection
Infections can lead to severe pneumonia in older people and those with compromised immune systems, according to Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children’s Hospital on Long Island, New York.
Symptoms of Legionnaires’ disease usually show up between two and 14 days after exposure.
New York City health officials are urging anyone who has visited the east side of Central Park or Manhattan’s Upper East Side since late June to watch for symptoms. (iStock)
“Legionella infections cause symptoms that are similar to other forms of pneumonia — fever, coughing, difficulty breathing, shortness of breath and chest pain,” Handel previously told Fox News Digital.
“Legionnaires’ disease is deadly but can be effectively treated if diagnosed early.”
The signs are similar to other types of pneumonia, and include the following:
- Cough
- Fever
- Shortness of breath
- Muscle aches and headaches
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Some patients may also experience nausea, diarrhea and confusion, the CDC noted.
Diagnosis, treatment and prevention
A medical professional can diagnose the infection with laboratory tests and chest X-rays.
The condition is typically treated with antibiotics. In cases of severe infection, hospitalization may be required for breathing support and IV hydration.
Around 10% of people who contract Legionnaires’ disease will die from those complications — and the mortality risk rises to 25% for those who get Legionnaires’ while staying in a healthcare facility, according to the CDC.
The bacteria is usually found in lakes, streams and other freshwater environments, but can grow in any area where water sits for a long time, according to the CDC. (iStock)
“Treatment needs to be early and aggressive,” Dr. Nathan Goodyear, an Arizona-based integrative medicine expert, previously told Fox News Digital. “Legionella infection is an intracellular infection that requires antibiotic treatment.”
Antibiotics that are appropriate for Legionella infection include Levofloxacin and Azithromycin.
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“Therapy can be prescribed orally in healthy individuals… but intravenous antibiotics often prove to be the initial option for treatment secondary to the pathogenicity of the disease,” Goodyear said.
Currently, there are no vaccines for Legionnaires’ disease.
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The best strategy to prevent infection is to reduce the growth and spread of the Legionella bacteria. The CDC recommends that building owners and managers use a water management program to reduce the risk.
“New Yorkers at higher risk, including anyone who is 50 and older, those who smoke or people with chronic lung conditions should be especially mindful of their symptoms and seek care as soon as symptoms begin,” city officials stated. (iStock)
To prevent serious illness from Legionnaires’, Goodyear recommends that all smokers kick the habit, and also emphasizes the need to “aggressively support” chronic pulmonary disease.
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“Increasing immune support (vitamin D3, vitamin C, Zinc) is required to counter the immune dysfunction associated with advancing age.”
Obesity is another foundational risk factor for all chronic inflammatory diseases, the doctor added.
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Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27.
In a post on Substack titled “The Day I’ll Never Remember,” she detailed a sudden episode that left her unable to recall the current month, year and president.
“I thought it was 2024. And I believed Joe Biden was president,” she wrote.
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The event occurred while Couric was attending the Aspen Ideas Festival in Colorado, during which she participated in two public panels — one on AI and one on journalism — both of which she cannot remember at all.
“I have no idea what we talked about, or of what occurred when the panels ended,” she said.
Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27. (Getty Images)
John Molner — Couric’s husband, who was in attendance at the festival and the two panels — also shared his account.
After the event, someone told Molner that Katie wasn’t feeling well. When he reached her, an EMT and a doctor were tending to her. “I could tell something was off,” he wrote. “It could have been altitude sickness, but Katie was definitely not all there.”
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At the hospital, when Couric struggled to recall the year, the president and her grandchildren’s names, doctors began checking for a stroke.
An MRI revealed no signs of stroke, which was a relief, but “Katie’s ‘fog’ became a lot more apparent,” Molner wrote.
John Molner, Couric’s husband, who was in attendance at the festival and the two panels, also shared his account. (Getty Images)
“She repeatedly asked me the same questions: ‘What was I doing before we got to the hospital?’ ‘Why am I at the hospital?’”
Couric was ultimately diagnosed with transient global amnesia, a sudden, temporary episode of memory loss that prevents a person from forming new memories and may also erase some recent memories, according to Mayo Clinic.
“The cause seems to be as mysterious as the brain itself.”
It is not caused by a stroke, seizure or head injury, and it usually resolves completely within 24 hours.
“[It’s] just a very weird neural episode that’s pretty uncommon and, at least in most cases, is a ‘one and done’ experience,” Molner said.
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Couric said she finally began feeling “like herself” again around 9 p.m. and went to sleep at 2 a.m.
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.”
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.” (Getty Images)
Data shows that approximately three to eight people per 100,000 will have an episode of transient global amnesia, with people 50 years of age and older at higher risk.
The specific cause of TGA is not known, but some experts believe it stems from a “temporary dysfunction in the brain’s hippocampus — the area responsible for creating new memories,” Couric shared.
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“Doctors believe this is driven by brief interruptions in blood or oxygen flow, or microscopic spasm in the blood vessels.”
Episodes could potentially be triggered by intense physical exertion, emotional distress, extreme temperature changes or migraines, experts say.
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Approximately 15% of patients will have a recurrence 10 years later.
“Why did this happen to me? Was the altitude an issue? Was I dehydrated? Tired? Stressed? The literature doesn’t seem to indicate that these are contributing factors, but the cause seems to be as mysterious as the brain itself,” Couric wrote.
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise. (iStock)
“All I know is that those hours will be forever lost. Someone described it as my brain failing to hit the ‘record button.’”
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“While this was a freaky occurrence, it could have been much more serious. So ultimately, I’m relieved — even though several hours of a Saturday in June will always be missing for me.”
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise.
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Older adults identified as “super movers” are about half as likely to develop cognitive impairment than their peers.
That’s according to a recent study led by Stony Brook Medicine in New York, which evaluated the cognitive function of 4,000 adults 80 and over who participated in multiple aging and longevity studies over several years.
Among this group, 6% to 10% were classified as super movers, which means they walk at a much faster pace than others of the same age and gender — at speeds comparable to people three decades younger.
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The super movers were found to have about half the risk of cognitive decline compared to seniors with typical gait speed.
The findings were published in the journal Neurology on June 16.
Older adults identified as “super movers” are about half as likely to develop cognitive impairment than their peers. (iStock)
“The study reinforces that mobility and brain health are closely connected,” lead study author Dr. Joe Verghese, MD, neurologist at Stony Brook Medicine, told Fox News Digital. “This suggests that preserving mobility may be an important marker of healthy brain aging and resilience.”
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The most intriguing finding, according to Verghese, was that super movers maintained cognitive function despite having similar dementia-related brain changes as their peers.
In postmortem brain analysis, there was no difference in dementia-related pathologies between the super movers and the slower walkers, the study stated.
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“This suggests they may possess resilience mechanisms that help preserve brain function even in the presence of age-related changes,” he said. “Understanding these resilience factors could lead to new strategies for promoting healthy brain aging.”
As the study was observational, there were some limitations, and it does not prove that walking faster prevents dementia, the researchers noted.
Super movers were found to have about half the risk of cognitive decline compared to seniors with typical gait speed. (iStock)
“Other factors, such as cardiovascular health, physical fitness or genetics, may also contribute to both faster walking and better cognitive outcomes,” Verghese said.
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This study adds to growing evidence that what’s good for the heart and muscles also benefits the brain, he noted, adding that “staying physically active remains one of the most effective, evidence-based ways to support healthy aging.”
“Walking speed is best viewed as a marker of overall health, not a treatment.”
“The broader message is that physical activity is important at any age,” Verghese said. “Walking is an easy step-up point because you don’t need any special equipment. You can do it inside or outdoors, and you can do it on a regular basis. You can walk with a dog, you can walk with a friend.”
Any activity is beneficial if it’s done regularly and with the right intensity, he added.
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Rather than just trying to walk faster, the neurologist recommends that seniors focus on maintaining mobility through regular physical activity, strength training, balance exercises and good cardiovascular health.
“Walking speed is best viewed as a marker of overall health, not a treatment,” Verghese noted.
Major public health guidelines from the CDC and U.S. Physical Activity Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking.
Major public health guidelines from the CDC and U.S. Physical Activity Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking. (iStock)
This can be achieved by walking 30 minutes a day, five days a week, or about 20 to 25 minutes most days. Another option is to engage in shorter sessions that add up over the day.
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“You have to do it within your health limitations and medical conditions,” Verghese advised. “So if there are any medical concerns, I would get your physician to clear you before starting exercise.” The good thing about walking, he added, is that you can start at a slow pace and then gradually build up to a brisker pace.
“And then adding on strength and balance training, whatever age you are, I think is also important.”
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