Almost 70 percent of American adults are considered obese under a revamped definition of obesity, according to a peer-reviewed study published in the JAMA Network Open and conducted by researchers affiliated with the Harvard Medical School and the Massachusetts General Hospital.
Traditionally, obesity was defined as having an elevated body mass index (BMI), calculated by dividing a person’s weight by their height. Earlier this year, the Lancet Diabetes & Endocrinology published a new definition of obesity, which incorporated anthropometrics, which include body measurements such as waist circumference, waist to height ratio, and waist to hip ratio, in addition to BMI, the study said.
An individual is now classified as obese under three conditions—if they have an elevated BMI plus at least one elevated anthropometric measure or a BMI greater than 40; or at least two elevated anthropometric measures irrespective of BMI; or excess body fat, according to the study.
Researchers analyzed the U.S.-based All of Us database to determine the prevalence of obesity under the new definition.
Of the 301,026 participants aged 18–80 years included in the analysis, 128,992 individuals (42.9 percent) were deemed to be obese under the traditional BMI-based criteria. But under the new definition, 206,361 individuals, or 68.6 percent, were considered obese. Obesity was found to be more prevalent with older age.
“We already thought we had an obesity epidemic, but this is astounding,” said co-first author Lindsay Fourman, according to an Oct. 15 report by The Harvard Gazette, the official news website for Harvard University.
“With potentially 70 percent of the adult population now considered to have excess fat, we need to better understand what treatment approaches to prioritize.”
According to the study, 78,047 participants (25.9 percent) who were not classified as obese under the traditional definition were reclassified as having obesity under the anthropometrics-only criteria. Among these individuals, 22.3 percent had a BMI traditionally classified as underweight or normal, with the remaining in the overweight category.
The Lancet Diabetes & Endocrinology guideline also introduced the concept of clinical and preclinical obesity. Clinical obesity refers to people who have obesity-associated organ dysfunction and/or physical limitation, while preclinical obesity pertains to individuals without such obesity-related issues.
Under the new definition, 36.1 percent of overall participants had clinical obesity, researchers found. Individuals with BMI plus anthropometric obesity were found to have a higher proportion of clinical obesity.
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