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.
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.
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.
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.
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?
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.
Early MASLD is not a chronic condition and can be reversed with lifestyle changes. (Photo credit: AI generated)
Fatty liver disease, as a term, has been used for several years to describe a state of excess fat accumulation in the liver. However, the perception is changing—once known as non-alcoholic fatty liver disease (NAFLD), the condition is now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD). The new term, according to leading diabetologist Dr V Mohan, offers more clarity because fatty liver is often associated with alcohol intake. However, even people who do not drink alcohol can develop this condition, and it has a metabolic angle to it. Despite the new name, the concern around fatty liver disease remains the same—can it be reversed?
In an interview with Health and Me, Dr Tushar Madake, consultant in the Department of Transplant Hepatology at Ruby Hall Clinic in Pune, spoke about the new name for fatty liver disease and why the metabolic angle is important.
Fatty liver disease may have a new name, but the concern around it has not changed. The current medical nomenclature identifies this as steatotic liver disease (SLD), with the previously identified NAFLD referred to as metabolic dysfunction–associated steatotic liver disease (MASLD). This classification places emphasis on the true source of the disease—metabolic health—and not necessarily alcohol intake.
One of the reasons why fatty liver disease is challenging to diagnose is the fact that it does not exhibit noticeable symptoms in its early stages. The organ functions without issues, and individuals might not suspect a problem. Unlike common assumptions, this condition affects people who are not necessarily overweight or who consume alcohol.
Some of the early symptoms include constant fatigue, an increase in abdominal fat storage, and a feeling of heaviness in the upper right quadrant of the abdomen. Changes in the skin, such as discolouration around the neck and armpits and skin tag development, can also be among the symptoms of the condition. Individually, these signs do not necessarily indicate any cause for concern. However, when present together with metabolic issues such as type 2 diabetes, obesity, high levels of cholesterol, and high blood pressure, they might signify liver impairment in the early stages.
Therefore, early diagnosis and monitoring are crucial. If you have these risk factors or experience these symptoms, it is recommended that you undergo tests for liver dysfunction and ultrasonography. In some cases, you may also need to undergo a scan, for instance, a FibroScan, for early detection of liver fibrosis.
Dr V Mohan, one of India’s leading diabetologists, said, “The encouraging news is that early-stage fatty liver is not a permanent condition. With consistent lifestyle changes, reversal is possible. Weight loss, regular physical activity, reduced intake of refined carbohydrates and fats, and higher protein consumption can all contribute to improved liver health.”
A healthy liver does not ask for much, just the right nutrition. (Photo credit: AI generated)
Many people follow what appears to be a reasonable eating pattern—meals at irregular hours, a light breakfast skipped in the name of time, and dinner pushed late into the evening. Yet the body, particularly the liver, does not respond well to such improvisation. What feels like a manageable routine on the surface can quietly accumulate into something more serious over months and years. The liver needs a consistent flow of nutrients to do its job, which includes managing blood sugar, breaking down fats, and supporting digestion. Long gaps between meals disrupt that rhythm.
Dr Babu U V, Director of R&D, Research & Development Centre, Himalaya Wellness Company, in an interview with Health and Me, spoke about the early symptoms of liver damage and explained how herbs can play a role in reversing it.
Before most people realise that something is wrong with their liver, they may already be experiencing symptoms that indicate potential liver issues. These symptoms may include fatigue, bloating, digestive discomfort, or feeling heavy after eating. Most of the time, these signs are dismissed as minor concerns.
When these issues are ignored or go unnoticed, it becomes difficult to recognise that the liver may be weakened by stress and not functioning optimally. If these problems persist over time, fat can begin to accumulate in the liver, along with other types of metabolic imbalances throughout the body.
To restore balance in the body, small changes in daily habits can lead to significant improvements. For example, eating at regular intervals helps the body maintain a consistent metabolism. Similarly, having lighter dinners and avoiding late-night eating can support better digestion and metabolism of food.
Some herbs commonly used in Indian households and traditional medicine may help support the liver’s healing process, especially when it is under stress.
Each of these herbs works in different ways—some aid digestion, while others help neutralise free radicals and reduce oxidative stress—thereby supporting a healthier lifestyle.
The liver is highly resilient; however, it requires consistent care. An irregular dietary pattern may not affect the liver immediately, but over time it can have a significant impact. Paying attention to simple habits—such as when and how you eat—and choosing foods that support liver health can go a long way in maintaining optimal liver function over the long term.
Credit: Canva
World Liver Day 2026 is observed every year on April 19 to raise awareness of the importance of liver health, focusing on preventing diseases such as cirrhosis and fatty liver through healthy lifestyles.
The liver is a key organ that filters blood, breaks down food, stores energy, and keeps the human body in balance.
However, rising metabolic risk factors, including high blood sugar and obesity, are increasingly driving cases of metabolic dysfunction-associated steatotic liver disease (MASLD).
Nearly one-third of the global adult population today lives with MASLD, which can remain asymptomatic for years but turn into deadly scarring (fibrosis), cirrhosis (advanced fibrosis and loss of some of the liver function), or even liver cancer.
The European Association for the Study of the Liver (EASL) launched World Liver Day in 2010. The day was established on April 19 to commemorate the EASL's founding in 1966.
This year, 2026, the World Liver Day theme is “Solid Habits, Strong Liver”. It emphasizes building consistent lifestyle habits, such as balanced diet, regular exercise, avoiding alcohol, and routine check-ups, to strengthen liver health and prevent diseases.
From filtering toxins to aiding in digestion and metabolism, the liver silently performs over 500 crucial functions in the body. The organ is also blessed with the ability to regenerate itself.
Yet data shows that 2 million lives worldwide are lost each year to liver disease. About 1.5 billion people suffer from chronic liver disease.
MASLD, formerly known as non-alcoholic fatty liver disease (NAFLD), has emerged as the most common liver condition worldwide. These patients suffer from either obesity, diabetes, metabolic syndrome, hypertension, or cholesterol problems.
According to a recent study published in The Lancet Gastroenterology & Hepatology journal, MASLD affected 1.3 billion people around the globe in 2023.
The alarming study estimates the numbers to further spike by over 38 percent to reach 1.8 billion cases by 2050, causing substantial health and economic impacts worldwide.
MASLD remains one of the most prevalent and rapidly growing liver conditions worldwide, with its prevalence marking a 143 percent increase between 1990 and 2023.
Also read: Why Regular Scans Are Crucial for Liver Cancer Patients: Doctors Explain
People with obesity, diabetes, central or abdominal fat, dyslipidemia, hypertension, and insulin resistance are more likely to have MASLD. Obesity is the strongest risk factor, with the likelihood rising steeply from overweight to severe obesity.
Other signs to watch for include
Certain lifestyle choices can accelerate liver damage, such as:
Early screening and detection are key to prevent irreversible stages. Yet liver disease can be prevented with lifestyle changes such as:
© 2024 Bennett, Coleman & Company Limited