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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Older adults who avoid meat in their golden years may be less likely to reach age 100 than their meat-eating counterparts, new research suggests.
Researchers tracked more than 5,000 adults aged 80 or older who were enrolled in the Chinese Longitudinal Healthy Longevity Survey.
Between 1998 and 2018, data showed that those who did not eat meat were less likely to reach their 100th birthday than those who consumed animal products regularly.
The findings seem to contradict previous studies that have linked vegetarianism and plant-based diets to lower risks of heart disease, stroke, diabetes and obesity.
Most evidence supporting the benefits of plant-based diets comes from studies tracking younger populations, the researchers noted.
The findings contrast with previous research praising plant-based diets for their positive influence on heart health. (iStock)
The study, published in The American Journal of Clinical Nutrition, points to losses in muscle mass and bone density with age, shifts that can increase the risk of malnutrition and frailty in the “oldest old.”
As people enter their 80s and 90s, the nutritional priority often shifts from preventing long-term chronic diseases to maintaining day-to-day physical function, experts say.
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“The headline ‘vegetarians over 80 less likely to reach 100’ sounds surprising, because it contrasts with decades of data linking plant‑forward diets to lower chronic disease risk earlier in life,” Erin Palinski-Wade, a New Jersey-based registered dietitian, told Fox News Digital.
“However, once you see that this research is limited to adults over the age of 80 who are also underweight — and that this link disappears with the consumption of eggs, dairy and fish — the results are less surprising.”
While diets earlier in life tend to emphasize avoiding long-term disease, older age necessitates nutrients and weight maintenance, experts say. (iStock)
In those over 80, restricting animal proteins may be less likely to promote longevity, according to Palinski-Wade, who was not involved in the study.
Eliminating all animal protein — particularly in a population that may already experience diminished hunger cues — can make it more difficult to meet adequate protein needs, potentially increasing the risk of nutrient deficiencies, the nutritionist said.
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In addition to a higher tendency to be underweight, older populations also face a greater risk of bone fractures due to lower calcium and protein intake.
Potential limitations
The lower rate of vegetarians reaching 100 was only observed in participants identified as underweight, the researchers noted. No such association was found in people who maintained a healthy weight.
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Because being underweight is already linked to greater frailty and mortality risk, the researchers noted that body weight may partly explain the findings, making it difficult to determine whether diet itself played a direct role.
Those incorporating animal-sourced products other than meat were just as likely to live to 100. (iStock)
Additionally, the shortened lifespans were not found in people who continued to eat non-meat animal products, such as fish, dairy and eggs.
Older adults with these more flexible diets were just as likely to live to 100 as those eating meat, as these foods may provide the nutrients necessary for maintaining muscle and bone health, the researchers noted.
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“This is an observational study, so it can only show associations, and does not prove that avoiding meat directly reduces the odds of reaching 100,” Palinski-Wade added.
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The researchers suggested that including small amounts of animal-sourced foods could help older seniors maintain essential nutrients and avoid the muscle loss often seen in those who stick strictly to plants.
Eliminating all animal protein — particularly in a population that may already experience diminished hunger cues — can make it more difficult to meet adequate protein needs, potentially increasing the risk of nutrient deficiencies. (iStock)
Palinski-Wade offered some guidance for those looking to optimize nutrition later in life.
“For adults in their 80s and beyond, especially anyone losing weight or muscle, the priority should be maintaining a healthy weight and meeting protein and micronutrient needs — even if that means adding or increasing fish, eggs, dairy or well‑planned, fortified plant proteins and supplements.”
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Strict vegan or very low‑protein patterns at that age should be carefully monitored by a dietitian or clinician, with attention to B12, vitamin D, calcium and total protein, according to Palinski-Wade.
“Younger and healthier adults can still confidently use plant‑forward or vegetarian patterns to lower long‑term chronic disease risk,” she added.
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In a dramatic turn of events that’s captured the attention of animal lovers worldwide, Punch — the young macaque at a zoo in Japan famous for his inseparable bond with a stuffed orangutan toy — has reached a major milestone in his journey toward social integration.
On Thursday, visitors and staff at the Ichikawa Zoological and Botanical Garden witnessed a breakthrough: Punch was seen cuddling with and hitching a ride on the back of a fellow macaque.
Punch’s story began with hardship. He was abandoned by his mother shortly after his birth in July 2025 — and to ensure his survival, zookeepers stepped in to hand-rear the primate.
On Jan. 19, 2026, the zoo officially began the process of reintegrating Punch into the “monkey mountain” enclosure.
The transition was initially fraught with tension.
Punch’s story began with hardship when he was abandoned by his mother shortly after he was born. To help him, zookeepers gave him a stuffed toy that he began dragging around everywhere he went. (David Mareuil/Anadolu via Getty Images)
As a hand-reared infant, Punch was bullied and ignored by the established group of monkeys.
He was often seen huddled alone with his orange plush companion while the rest of the troop interacted.
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In an official statement released Feb. 27, the Ichikawa Zoological and Botanical Garden detailed the meticulous care behind this process.
Previous viral videos showed Punch bullied by the rest of the troop, running to his plushy toy for comfort. (David Mareuil/Anadolu via Getty Images)
“From an animal welfare perspective, our primary goal is to reintegrate Punch with the troop,” the zoo said.
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The strategy involved nursing Punch within the enclosure, so the troop could recognize him as one of their own, and pairing him with a gentle young female macaque prior to his full release to build his confidence.
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The latest footage, captured by X user @tate_gf, suggested the zoo’s patience is paying off.
The video shows Punch seeking physical contact not from his toy, but from another monkey — eventually climbing onto its back for a vital social behavior for young macaques: the “piggyback ride.”
The zoo’s strategy appears to be paying off: Punch, shown at far left, was recently seen riding on the back of a fellow macaque. (David Mareuil/Anadolu via Getty Images)
While Punch still carries his stuffed toy for comfort during moments of perceived danger, the zoo remains optimistic about his progress.
The organization cited the successful 2009 case of Otome, another hand-reared macaque who eventually outgrew her stuffed toy, successfully integrated — and went on to raise four offspring of her own.
The zoo has had crowds coming to see Punch, with hundreds of people lining up to get inside to see the young star, according to reports.
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“I’m hoping Punch has a good life like everybody else does, and think he’s a cute little guy,” one person commented online.
“Such a precious baby,” another person wrote.
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