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.
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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.
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An individual's income, education, gender and place of residence can impact their risk of developing chronic diseases, as well as their access to diagnosis and treatment, according to a new World Health Organization (WHO) report.
The report highlights how social and economic inequalities affect the burden of noncommunicable diseases (NCDs) like cancer, cardiovascular diseases, diabetes and chronic respiratory diseases.
Published on October 20, State of Inequality: Noncommunicable Diseases and Their Risk Factors is WHO's first comprehensive global assessment of inequalities in NCDs and their risk factors. The report is based on data sources from nine countries and examines 35 indicators, using national data that collected over the past decade.
NCDs account for about three-quarters of deaths worldwide but their impact is not shared equally across different countries and their populations. The report examines how differences in economic status, education, sex, age, disability, employment, migration status and location influence disease risks and access to healthcare.
“This is the first effort to systematically measure inequalities in NCDs and their risk factors on a global scale,” said Dr Ahmad Reza Hosseinpoor, who leads WHO's health inequality monitoring team. “The findings show which populations are being left behind.”
The report found that people with lower levels of education in low and middle income countries tend to have higher rates of hypertension and diabetes.
Education can affect access to credible health information, opportunities to make informed health decisions and the capability to navigate technically complex healthcare services.
Income becomes a key factor that affects whether people's ability to afford nutritious food, preventive care, medicines and routine medical check-ups.
The report found that the poorest and least-educated women were less likely to receive cervical cancer screening. Tobacco use was also higher among men who were less educated than their educated counterparts.
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Differences in healthcare access and risks were also observed between men and women. Men were more likely to use tobacco and consume alcohol, but men with hypertension were less likely to be diagnosed and treated than women.
Women were less likely to meet recommended physical activity levels, while obesity was more common among women, particularly in low and middle-income countries.
Geography was another key factor as in many underprivileged countries, people living in rural areas had less access to hypertension diagnosis and treatment, as well as cervical cancer screening.
Rural households could also face greater exposure to household air pollution, while urban populations often experienced greater exposure to outdoor air pollution.
People with disabilities and migrants may also face financial, administrative, geographical or language barriers that make prevention, screening and treatment harder to access.
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WHO said countries should use inequality data to identify marginalised populations who face barriers to enable direct prevention and treatment services towards them.
The report recommends expanding interventions to reduce NCD risks, improving access to screening and treatment in weak communities, and collecting data that reveal differences between population groups.
“Inequality data are not simply about documenting differences – they are a tool for action,” said Dr Alain Labrique, director of WHO's Data, Digital Health, Analytics and AI Department. “They help countries better tailor policies and programmes, identify gaps in coverage and track whether progress is reaching all population groups.”
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People diagnosed with attention-deficit/hyperactivity disorder (ADHD) had a 71% higher rate of death from any cause than those without the condition, new review published in JAMA Network Open states. The findings highlight health risks that extend beyond ADHD's core symptoms.
The study also found higher rates of death by suicide and injuries. ADHD medication, on the other hand, was reported to cause overall lower mortality.
Researchers from University College London (UCL) and the University of Liverpool reviewed 19 observational studies involving nearly 16 million people across three continents.
The review found that people with ADHD had an 89% higher rate of death by suicide and a 55% higher rate of death from intentional or unintentional injuries, compared to people without ADHD.
Deaths from natural causes, including those related to physical health conditions, were also 27% higher.
Researchers said several factors could contribute to these findings. People with ADHD may experience difficulties with impulse control and emotional regulation, as well as higher rates of other mental health conditions. Challenges with attention may also contribute to accidental injuries, including road accidents.
Physical health risks due to lifestyle may play a role too. Smoking, alcohol use, substance abuse and accessing healthcare could affect these results.
Senior author Professor Joshua Stott of UCL said, “We found that people with ADHD face an increased risk not only of death by suicide and injury, but also of deaths by natural causes, adding to evidence that health inequalities faced by people with ADHD are broad and wide-ranging.”
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The review found that people with ADHD who took prescribed medication had a 25% lower risk of death from any cause than those who did not take medication.
However, this finding was based on only three of the 19 studies included in the review. The researchers said that more research is needed to understand whether medication directly reduces mortality risk.
First author Lucy Corrigan of the University of Liverpool said, “Our findings provide early evidence to suggest that medication may play an important role in supporting the health of people with ADHD, but this is based on a small number of studies and further research is needed to clarify this link. And medication is just part of the story; many people with ADHD benefit from comprehensive, long-term treatment and support.”
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The researchers said that all the studies included in the review were observational. This means the results show associations and cannot establish that ADHD itself causes early death or that medication prevents it. The studies also differed in their methods and in the size of the risks they reported.
Stott said, “ADHD is not by definition a life-limiting condition as the right support and treatment can help people with ADHD to live long and healthy lives. Our findings underscore the importance of ensuring that everyone who may have ADHD has access to accurate diagnosis and treatment. While ADHD diagnosis rates have risen in recent years, they may still lag behind actual prevalence, particularly for older age groups where mortality risk may be most pertinent.”
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Morning walks are a popular part of many older adults’ daily routines. But is walking alone enough to maintain bone strength and prevent osteoporosis as we age?
Walking 30–40 minutes every day is a good habit. However, it may not be enough to maintain bone and muscle strength as we age. A person may walk daily and still struggle to get up from a low chair or maintain balance on an uneven surface. These are important signs of functional strength that deserve as much attention as daily step counts, experts said on World Osteoporosis Day.
Falls are a significant concern among older adults worldwide. A 2022 systematic review and meta-analysis of 104 studies estimated that 26.5% of older adults globally experienced falls. In India, a 2026 analysis of data from the Longitudinal Ageing Study in India found that 11.56% of adults aged 60 and older reported a history of falls. Chronic joint disease was among the factors independently associated with falls.
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Dr. Siddhart Yadav, Senior Consultant, Orthopedics and Joint Replacement Surgery, Apollo Hospitals, Navi Mumbai, told HealthandMe that bone density and muscle mass tend to decline with age.
“In women, bone loss can accelerate after menopause, while men too are at risk of age-related bone loss. When weaker bones are combined with reduced muscle strength and poor balance, even a relatively minor fall can result in a fracture, particularly around the hip or wrist,” he said.
“While women are hit hardest, often assuming household chores are adequate exercise, men are equally vulnerable as muscle mass silently declines after 50. In both, excess weight paired with weak muscle leaves weaker bones exposed to fractures during simple falls,” Dr. Thineshchandar Andiappan, Senior Orthopaedic and Joint Replacement Surgeon, Athulya Geriatric Hospital told HealthandMe.
A casual morning walk alone may not provide enough stimulus to maintain bone density, muscle strength, and balance. Experts recommend combining walking with progressive resistance and strength training. Starting in your 40s can help preserve strength, but it is never too late to begin an appropriate exercise routine.
Along with regular walking, older adults should include simple strength and balance exercises in their routine.
Dr. Siddhart suggested chair sit-to-stands, supported squats, heel raises, and resistance-band exercises to help maintain the strength needed for everyday activities. Light dumbbell exercises for the upper body can also help strengthen the arms, shoulders and other upper-body muscles.
Exercises should be introduced gradually and tailored to individual health and mobility, particularly for people with osteoporosis or a history of fractures.
A 30-40-minute walk is beneficial, but it does not have to be completed in one stretch. If the muscles begin to feel tired, taking a short break of two to three minutes before resuming the walk is reasonable.
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Along with exercise, adequate nutrition supports bone and muscle health. Calcium-rich foods such as milk, curd, paneer, ragi and sesame, together with adequate protein, can help meet nutritional needs. Vitamin D levels should be assessed when clinically indicated.
“Falls in elderly persons happen more often due to instability, muscle weakness, and other reasons. It is very important to address all the issues in addition to the management of osteoporosis for preventing such fractures. The comprehensive treatment will include a good diet, adequate sunlight exposure, in addition to exercises, which must involve weight training and stability-building training,” Dr. V Singaravadivelu, Senior Consultant and Academic Lead, Orthopaedic Surgery, Kauvery Hospital told HealthandMe.
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