A new report published in The Lancet Diabetes & Endocrinology challenges the conventional definition of obesity, and urges a shift from the reliance on Body Mass Index (BMI) to a more nuanced approach. This is supported by over 50 global medical experts. The report also recommends splitting the term "obesity" into two categories: "Clinical obesity" and "Pre-clinical obesity". This aims to improve diagnosis and treatment for over a billion people worldwide living with obesity.

Clinically Obese

This applies to individuals whose obesity has progressed to a disease state, manifesting in organ damage, heart disease, type 2 diabetes, or other health complications. These individuals could also experience symptoms like breathlessness, joint pain, or impaired daily functioning. Treatment also involves medical interventions, including weight-loss medications or surgery.

Pre-Clinic Obese

Whereas the term "pre-clinic obese" refers to those who are overweight but not yet exhibiting health issues. While they may be at risk of developing obesity-related conditions, their organ function and overall health remain intact. What they need is preventive care, which includes dietary guidance, counselling, and regular monitoring to avoid and reduce future health risks.

What does the study say?

The study, led by Professor Francesco Rubino from King's College London emphasizes that obesity is not one-size-fits-all condition. This means it should rather be treated as a spectrum as some individuals maintain normal organ function despite being classified as obese. There are others who may face severe health complications too. However, the current method of calculating obesity based on BMI often leads to misdiagnosis or inadequate care.

The report also states that BMI, while is useful for analyzing population trends, is a flawed unit of measuring individual health. Therefore, there is a need to redefine obesity, and healthcare professionals can provide more precise care by distinguishing those who need immediate medical intervention and those who require preventive strategies.

Limitations of BMI, Why It Falls Short?

BMI is used to classify individuals as underweight, healthy weight, overweight, or obese based on their height and weight. It is calculated by dividing weight in kilograms by health in meters squared. However, there are reasons while it falls short.

•Muscle vs Fat: Athletes or muscular individuals often have high BMIs despite the low body fat

•Fat Distribution: BMI does not measure fat around the waist or organs, which could be more dangerous to one's health.

•Individual Health Variation: It also overlooks the specific health conditions such as heart diseases or diabetes, or any other, while evaluating a person's category in terms of weight.

ALSO READ: Is It Time To Say Goodbye To BMI?

Scope Of Study

By redefining obesity, the study could transform the approach to diagnosis and treatment. It can focus on individual health risks rather than BMI alone. Healthcare providers can also offer tailored care. This also will ensure hat weight-loss medications like Wegovy or Mounjaro are prescribed only to those who genuinely require it.

As per Professor Louise Baur from the University of Sydney, a Children's obesity expert said that this redefinition allows both adults and children to receive more appropriate care while reducing over-diagnosis and unnecessary treatments.

GLP-1 receptor agonists are a modern class of medicines that have changed the treatment of type 2 diabetes and obesity. In simple terms, they help the body respond to food more smartly. After eating, the intestine naturally sends signals that help regulate sugar and appetite levels.

GLP-1 RA medicines imitate this signal. As a result, blood sugar rises less after meals, appetite becomes more controlled, and many people feel full with smaller amounts of food. This is why these medicines are used not only for diabetes, but also for weight reduction in selected people.

GLP-1 Drugs: Not A Miracle Injection

These medicines are important because their benefits can go beyond sugar control alone. Studies and current diabetes guidelines show that some GLP-1 RAs can reduce body weight, improve long-term sugar levels, and lower the risk of major heart-related problems in people who have type 2 diabetes and high cardiovascular risk.

Recent guidance also supports their use in some people with chronic kidney disease when cardiovascular risk reduction is an important goal. This does not mean every drug in the group is identical, but it means the class has become medically important for more than just lowering sugar.

For the general public, one important point is that these are not “miracle injections.”

They work best when combined with better food choices, regular walking or exercise, good sleep, and medical follow-up. They are usually started slowly because the commonest side effects are stomach-related, such as nausea, vomiting, constipation, loose motions, or a feeling of fullness.

Not everyone is suitable for them, and the decision depends on a person’s diabetes status, weight, heart or kidney disease, other medicines, and cost. Used properly, GLP-1 RAs are powerful tools that can improve health, but they should always be taken under medical supervision.

GLP-1 Drugs: Urgent Need to Curb Misuse

So Indian Medical Association (IMA) is planning to seek a mandate restricting prescriptions of GLP-1 drugs to certified endocrinologists/diabetologists or MD general medicine practitioners to curb indiscriminate use and safeguard patient safety as access expands, many media report in August last year about rampant misuse of GLP1 weight loss drugs by cosmetologists, physiotherapists, dermatologists, general MBBS clinicians, and even ayurveda, and other non-modern medicine practitioners.

Many MBBS, physiotherapists, and non-modern medicine practitioners are prescribing GLP1 drugs to people who neither have diabetes nor any comorbidity or acute obesity, but purely for cosmetic reasons to lose some weight that can be otherwise easily done with some lifestyle changes like exercise and diet.

It is a duty of the government to take care of it because there is a lot of misuse and misprescription that needs to be curbed immediately, because these medicines also have side effects.

We will write to the government to take necessary action to stop the misuse of the drug. We will discuss it in our meeting in the first week of April 2026.

One in four or 25 percent of adults with type-2 diabetes in India also suffer from liver fibrosis, according to an alarming study published in The Lancet Regional Health Southeast Asia journal today.

With data from more than 9,000 patients across the country, it is the largest ever real-world survey of liver fibrosis in type 2 diabetes from any low- or middle-income country.

While fatty liver disease has been touted as the most common liver condition among diabetes patients, the new study established liver fibrosis as the real danger among people with high blood sugar.

“Type 2 diabetes is closely linked to fatty liver disease (also known as MASLD). But how common is liver Fibrosis — the real danger — in Indian diabetics? Our answer: 1 in 4 has clinically significant liver fibrosis. One in 20 already has probable cirrhosis. Most had no symptoms. We propose liver fibrosis as the ‘4th major complication’ of diabetes,” said Ashish Kumar, from Ganga Ram Postgraduate Institute of Medical Education and Research (GRIPMER), from Sir Ganga Ram Hospital, in a post on social media platform X.

Also read: About 84% IT Employees Are Suffering With Fatty Liver Disease - Why Screenings Are Necessary For Corporate Workers

What Did The Study Find?

Fatty liver is typically the first and reversible stage of liver disease, where excess fat builds up in liver cells. Left untreated, it progresses to liver fibrosis, which is the excessive accumulation of scar tissue (collagen) in the liver resulting from chronic inflammation. The condition then progresses to the third and late stage, irreversible scarring (fibrosis) of the liver. The final stage is liver cancer.

The DiaFib-Liver Study included a total of 9,202 adults with type-2 diabetes patients who underwent FibroScan (VCTE) to assess liver fibrosis in routine diabetes care.

Of these:

• 26 percent had clinically significant fibrosis,
• 14 percent had advanced fibrosis,
• 5 percent had probable cirrhosis
• 65 percent had fatty liver disease.

• obesity
• dyslipidaemia
• kidney problems
• diabetes duration ≥10 years.

Fibrosis: The Screening Target

The study suggested the urgent need to integrate fibrosis screening into national diabetes programs.

“One in four adults with type 2 diabetes in India has clinically significant liver fibrosis and one in twenty already has probable cirrhosis, establishing advanced liver disease as a 'fourth major complication' of diabetes,” said the researchers.

“The DiaFibLiver Study calls for: Fibrosis — not steatosis — as the screening target. FibroScan integration into routine diabetes care. Moving beyond ultrasound-based referral,” Jha said.

“We hope this data from India adds to the global conversation on diabetes and liver disease,” he added.

Also read: The Silent Rise of Fatty Liver Disease: How India-Specific Guidelines Can Help

The findings highlight the urgent need to:

• move beyond steatosis
• systematically integrate fibrosis assessment into routine diabetes care,
• deploy non-invasive tools such as vibration-controlled transient elastography (VCTE) in community practice
• define screening strategies,
• evaluate therapeutic interventions.

Everyday Habits That Harm the Liver

Certain lifestyle choices can accelerate liver damage, such as:

Overeating processed or fried foods

High sugar intake (soft drinks, sweets, desserts)

Physical inactivity or prolonged sitting

Ignoring health issues like diabetes or hypertension

Crash dieting or taking unprescribed supplements.

How To Improve Liver Health?

Early screening and detection are key to prevent irreversible stages. Yet liver disease can be prevented with lifestyle changes such as:

• Eating a balanced diet with vegetables, fruits, whole grains, and lean protein
• Engaging in at least 30 minutes of exercise daily
• Staying hydrated to help the liver flush out toxins
• Avoiding alcohol and smoking
• Avoiding self-medication and unnecessary pills
• Getting routine health screenings.

New Delhi: Every day, the brain processes hundreds of choices. Most pass unnoticed: what to wear, which route to take, what to eat. But accumulated over hours and across competing demands, this constant decision-making exacts a cost. Decision fatigue is the gradual erosion of the brain’s capacity to make good choices, and over time it affects both mental functioning and physical health. Dr Shivi Kataria, Consultant – Psychiatry, CK Birla Hospitals, Jaipur, addressed the problem of plenty and said that it could take a toll on mental health in certain circumstances.

Read more: India Launches 1st Repository Of Data On Major Psychiatric Disorders

What are the signs?

The earliest signs tend to be emotional. Simple decisions start to feel disproportionately heavy. Choosing between two options takes longer than it should. Irritability surfaces. Tasks that once felt manageable begin to pile up as the mental energy required to engage with them thins. Procrastination, self-doubt, and a general withdrawal from decisions are common responses, with the brain essentially rationing what little capacity remains.

Cognitive symptoms follow. Concentration narrows. Judgement becomes less reliable. Small errors accumulate. People in this state often describe feeling mentally stuck, present in the room but unable to engage with any clarity or momentum.

The physical dimension is frequently overlooked. Headaches, low energy, disrupted sleep, and difficulty sustaining attention are all associated with sustained decision overload. These symptoms register what prolonged mental strain produces in the body and are worth taking seriously.

Who is most at risk?

Decision fatigue affects most people at some point, but the load is not evenly distributed. Professionals in high-responsibility roles, caregivers, and anyone managing multiple competing demands make a disproportionately high number of decisions each day. By the end of a long day, the quality of choices made about food, purchases, relationships, or work often reflects exhaustion more than intention.

Read more: Smartphone Overuse Linked To Rising Risk Of Eating Disorders Among Youth, Study Finds

Is there a solution?

Reducing the number of decisions that require active thought each day is the most direct intervention. Fixed routines for meals, schedules, and recurring tasks remove the need to deliberate repeatedly over the same ground. This is conservation of mental energy, and it compounds over time.

Important decisions are better made earlier in the day, when the brain is rested and cognitive resources are intact. Short breaks during sustained work periods allow partial recovery. Even brief physical activity or deliberate rest between decision-heavy tasks restores some capacity.

The brain has a finite decision-making budget each day. Spending it on low-stakes choices leaves less available for the ones that carry real consequence.