BMI has been the benchmark in evaluating health and fitness for many years. The formula is quite simple: weight in kilograms divided by the square of height in meters. This would easily tell if one is underweight, within the healthy weight range, overweight, or obese. But with new research findings, scientists are now questioning its accuracy and usefulness as a total measure of body composition.

The report, published in The Lancet Diabetes & Endocrinology, has sparked a global conversation on rethinking BMI. Supported by more than 50 international medical experts, the report suggests classifying obesity into "clinical" and "pre-clinical" types for better diagnosis and treatment. The shift underscores a growing consensus: BMI alone may not tell the full story of your health.

While BMI is simple to calculate and universally accessible, it is far from perfect. It does not consider muscle mass, bone density, or fat distribution, leading to misleading conclusions in some cases. For example, athletes with a high muscle mass may be considered overweight, whereas individuals with normal BMI might carry unhealthy amounts of visceral fat.

A landmark study in JAMA Network Open studied more than 155,000 postmenopausal women and found that women with a normal BMI but a waist size over 35 inches were more likely to die from heart disease or cancer compared with their counterparts whose waists are smaller. That makes a great case for how BMI can be insufficient and fat distribution must be factored into account.

Not all body fat is equal. Subcutaneous fat, which lies just beneath the skin, is relatively harmless. The real health danger lies in visceral fat—fat that surrounds internal organs. Unlike subcutaneous fat, visceral fat is metabolically active, releasing stress hormones like cortisol and inflammatory substances that raise blood pressure, blood sugar, and cholesterol levels. These effects significantly increase the risk of conditions such as heart disease, type 2 diabetes, and certain cancers.

BMI Isn't Always the Best Measure of Body Composition — Here's What to Use Instead

Since BMI is not the most reliable measure, scientists and doctors have sought other means to measure body composition more accurately.

1. Waist Circumference

A simple tape measure can provide valuable insight into your health. Measure your waist at the level of your belly button, ensuring the tape is parallel to the ground. For women, a waist measurement under 35 inches is considered healthy, while for men, the goal is under 40 inches.

2. Waist-to-Hip Ratio

This is the ratio of your waist circumference to that of your hips. To calculate it, divide your waist measurement by your hip measurement. According to the National Center for Biotechnology Information, a ratio under 0.8 for women and 0.9 for men is considered healthy.

3. Body Roundness Index (BRI)

A newer method that seems to be receiving more attention involves the Body Roundness Index or BRI: height, weight, and girth are placed together to represent a more advanced view of what body composition says. Research presented in JAMA Network Open offers evidence that this BRI predicts mortality risk greater than BMI in some cases- a promising weapon for public health.

Also Read: Using BMI To Classify People As Obese Is Flawed Say Experts

Ways To Cut Off Unhealthy Fat

The good news is that visceral fat responds well to lifestyle changes. Here are three evidence-based strategies:

Time-Restricted Eating

Adopting an eating window of 12 hours—such as from 7 a.m. to 7 p.m.—can significantly reduce visceral fat, according to a study published in Nutrition Research Reviews. This approach not only helps control caloric intake but also reduces late-night snacking, a known risk factor for abdominal obesity.

Limit Alcohol Intake

Excessive alcohol consumption is associated with increased belly fat. A 2017 study published in Public Health Nutrition revealed that alcohol increases the levels of insulin and encourages the storage of fat in the abdominal area. Limiting alcohol to occasional indulgence helps avoid weight gain in this region.

High-Intensity Interval Training (HIIT)

HIIT involves repeated episodes of high-intensity exercise separated by periods of rest. A review in *Sports Medicine* concluded that HIIT is very effective in reducing visceral and total body fat. It can be noted that adding just 20 minutes of HIIT two times a week can make all the difference.

The reliance on BMI as a sole indicator of health is increasingly being challenged. While it remains a convenient screening tool, its limitations necessitate a broader approach that considers factors like fat distribution, waist circumference, and new metrics such as BRI.

In the simplest of words, health is multi-dimensional, and shifting perspectives from considering weight solely to broader measures of body composition will get people a much clearer understanding of where their health risks are so that they can take the action required for a better quality of life. Through adjustment to diet, exercise, or perhaps through innovative metrics like BRI, health is well within reach of the individual.

This dynamic conversation raises the point about personalized health screenings, which helps everyone get more relevant tools fitting their unique lives and circumstances. As body composition research is enhanced, so do the futures look brighter and brighter for the times of measurement when it comes to health.

Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology.

Association of Normal-Weight Central Obesity With All-Cause and Cause-Specific Mortality Among Postmenopausal Women. JAMA Netw Open. 2019

Waist-Hip Ratio. NIH.

Physiological responses to food intake throughout the day. Nutr Res Rev. 2014

Association between abdominal obesity and alcohol drinking pattern in normal-weight, middle-aged adults. Public Health Nutr. 2017

Weight loss from GLP-1 drugs like Ozempic may also result in some muscle loss, not just fat. Researchers are, therefore, testing whether a second drug could help protect muscle while people lose weight.

According to new trial data, an experimental drug developed by Regeneron called trevogrumab reduced muscle loss when it was taken along with Novo Nordisk's semaglutide, the active ingredient in Ozempic and Wegovy.

It could be a significant development in the GLP-1 weight loss drugs market as researchers are focusing on what kind of weight people are losing rather than how much.

Ozempic Results In Muscle Loss

Ozempic contains semaglutide, a GLP-1 drug that helps lower blood sugar and reduce appetite. As people eat less consistently and lose weight, the body can lose both fat mass and lean mass, which includes muscle.

Reuters reported researchers found that patients who took semaglutide lost 6.7% of their lean muscle mass over 26 weeks in one part of the trial.

This also does not mean that everyone on Ozempic will lose a large amount of muscle. Diet, physical activity, protein intake, age and starting muscle mass can all influence body composition during this weight loss.

But preserving muscle is crucial, especially for older adults and people who already have low muscle mass.

Also read: 2 Indians Charged In US Over Fake Ozempic Scheme: How To Spot Counterfeit GLP-1 Drugs

Could Trevogrumab Help?

Trevogrumab, developed by Regeneron, belongs to a class of drugs that targets myostatin, a protein involved in regulating muscle growth and maintenance.

While semaglutide helps drive weight loss, trevogrumab may help prevent the body from breaking down as much muscle during that process.

In the trial, people who received semaglutide alone lost 6.7% of their lean muscle mass over 26 weeks. Those who received semaglutide along with 75 mg of trevogrumab lost 3.3%, while the group receiving 25 mg lost 4.7%.

That means the higher dose nearly halved the lean-mass loss seen with semaglutide alone.

Also read: 21% In 80 Weeks: Lancet Study Finds Lilly’s Retatrutide Delivers One Of The Biggest Weight Losses Ever

More About The Trial & Trevogrumab

The drug is experimental and has not been approved as a treatment for people taking GLP-1 drugs.

The trial involved nearly 1,000 people aged 18 to 65, and the researchers are continuing to study trevogrumab. Regeneron has selected the 75 mg once-weekly dose for further studies and plans another mid-stage trial involving people over 65.

The larger trial initially included another experimental drug, garetosmab. Two people receiving higher-dose trevogrumab in combination with garetosmab died during the first 26 weeks.

One death had an undetermined cause in a person with multiple cardiovascular risk factors, while the other was due to cardiac arrest in someone with a history of cardiovascular disease. Regeneron said it will not continue developing the triple-drug combination.

Maintaining Muscle Mass During Weight Loss

Muscle is important for strength, mobility, balance and everyday physical function. Losing too much muscle during rapid weight loss could be particularly concerning for older adults, who are already at risk of age-related muscle loss.

This is why the next generation of obesity treatments may focus on more than the number on the weighing scale.

Regeneron executive Boaz Hirshberg said, “What we want to do is concentrate on the quality of weight reduction. We want to find the best way to approach weight reduction, especially in vulnerable patients.”

Most athletes and gym-goers cannot help but boast about the many benefits of creatine. When it comes to boosting performance and supporting muscle growth, this supplement is trusted often.

But a new study suggests that creatine may also have benefits when you are out of the gym. But the researchers caution that it does not mean that creatine can replace exercise, especially strength training.

Researchers at Texas A&M University found that adults who took creatine gained lean tissue and improved muscle strength even when they did not follow a structured exercise programme. The 12-week study was published in the Journal of the International Society of Sports Nutrition.

Could Creatine Help Build Muscle?

The study is based on 64 healthy adults aged 45 to 65 who completed the 12-week intervention. Participants were divided into exercise and non-exercise groups and were randomly assigned to take either 10 grams of creatine monohydrate or a placebo every day.

The exercise group followed resistance and aerobic training three times a week, while the other participants did not follow a structured exercise programme.

Among those who did not exercise, those taking creatine gained about 2.4 pounds (1.1 kg) of lean tissue over 12 weeks. They also improved their leg and bench-press strength. Those who combined creatine with exercise saw even greater improvements in strength.

Creatine occurs naturally in the body and helps cells produce energy. Most of the body's creatine is stored in skeletal muscle, where it helps regenerate ATP, the main source of energy for the cells.

This is one reason creatine has traditionally been associated with better performance during short, intense exercise. The researchers believe its ability to support cellular energy may also help preserve or even increase lean tissue, especially in middle-aged adults.

Also read: 21% In 80 Weeks: Lancet Study Finds Lilly’s Retatrutide Delivers One Of The Biggest Weight Losses Ever

Creatine & Weight Loss

The study also studied whether creatine could help people preserve muscle while losing weight.

Participants following the exercise and low-calorie diet who took creatine gained nearly 3 pounds of lean tissue while reducing fat mass.

The exercise and diet group taking placebo showed little change in lean tissue. Creatine was also associated with a greater reduction in body fat percentage. This could be relevant during weight loss, when some muscle loss may occur along with fat loss.

No, Creatine Will Not Replace Exercise

The small study is lasted only 12 weeks and also involved healthy adults aged 45 to 65, so the results cannot be applied to younger people, older adults with health conditions, or other people with muscle disorders.

The findings are also somewhat different from the much larger body of evidence showing that creatine's most established benefits occur when it is combined with resistance training.

Maintaining muscle becomes crucial with age. Loss of muscle mass and strength can affect mobility and physical function. The Texas A&M researchers say the findings add to growing interest in creatine as a tool for healthy ageing and maintaining muscle.

Eli Lilly’s highly anticipated GLP-1 weight-loss drug retatrutide has delivered nearly 21% average weight loss in people with type 2 diabetes and obesity, according to results from a large Phase 3 trial published in The Lancet. In an ever-expanding weight loss medication market, retatrutide is already showing significant promise in obesity and diabetes management.

The drug, retatrutide, is being developed by Eli Lilly and is not approved by the FDA yet. In the TRIUMPH-2 trial, people receiving the highest 12 mg dose lost an average of 20.8% of their body weight over 80 weeks, equivalent to about 49.6 pounds or 22.5 kg.

The findings about retatrutide's trial were presented at the European Association for the Study of Diabetes (EASD) annual meeting in Milan and published simultaneously in The Lancet.

How Is Retatrutide Different From Other GLP-1 Drugs?

Retatrutide is a triple agonist because it activates three hormone receptors:

• GIP
• GLP-1
• Glucagon

GLP-1-based medicines are already widely used for diabetes and obesity. Retatrutide activates GIP and glucagon pathways as well, creating a three-way approach to manage appetite, blood sugar and metabolism. The drug is given once weekly by injection and remains experimental and investigational.

Also read: World Heart Day: You Feel Healthy. But Plaque May Already Be Building In Your Arteries In Your 20s

Retatrutide Weight Loss Results

TRIUMPH-2 included adults with obesity or overweight and type 2 diabetes. Participants receiving retatrutide were assigned to 4 mg, 9 mg or 12 mg doses and followed for 80 weeks. The average weight loss was:

• 4 mg: 12.7%
• 9 mg: 19.1%
• 12 mg: 20.8%
• Placebo: 4.0%

The response was even greater among participants who started the study with a BMI of at least 35. Those receiving 12 mg lost an average of 23.4% of their body weight, or about 60.8 pounds.

By week 80, 59.5% of people taking 12 mg no longer met the BMI criteria for obesity.

Also read: 100% Blockage At 18, 25% Patients Under 40: On World Heart Day, Cardiologists Reveal An Alarming Heart Attack Pattern

Retatrutide Blood Sugar Results

Retatrutide not only led to one of the biggest weight losses ever seen, it also improved HbA1c, a measure of average blood glucose over the previous two to three months. At 80 weeks, HbA1c fell by:

• 1.4 percentage points with 4 mg
• 1.6 percentage points with 9 mg
• 1.5 percentage points with 12 mg

Up to 40% of participants receiving retatrutide achieved an HbA1c below 5.7%, which is within the normal range.

The Next Big Weight-Loss Drug?

The results are certainly seem promising, particularly as people with type 2 diabetes can sometimes lose less weight with obesity medicines than people without diabetes.

Retatrutide's combination of substantial weight loss and improved blood sugar control makes it an important drug to watch in a competitive GLP-1 market.

Since it's not approved yet, more evidence will be needed on its long-term safety, cardiovascular effects and how its benefits compare with existing treatments. It is also worth remembering that the 20.8% figure represents an average, not the amount every participant lost.

Retatrutide's development is a sign that obesity and diabetes treatment is extending beyond just managing blood sugar. The next generation of drugs is all about targeting weight, glucose and metabolism together.