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.
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Every medicine has its own set of side effects, and Dr Dmitry Yaranov, a Russia-based cardiologist, who specializes in heart failure, advanced heart failure, heart transplantation, and mechanical circulatory support, says that some everyday drugs can pose hidden risks to the heart. His message is not meant to spark fear but to encourage awareness about medications we often assume are completely harmless.
Below are five categories of common drugs that Dr. Yaranov believes deserve more caution, especially for those with existing heart issues.
These are your everyday painkillers, which includes ibuprofen or naproxen. While they are go-to options for headaches, fever, or muscle cramps, Dr Yaranov says that its frequent use could strain the heart.
These drugs reduce inflammation by blocking certain chemical pathways, but they also make the body retain salt and water. This can:
Dr. Yaranov suggests discussing long-term or frequent NSAID use with a doctor, instead of using them casually.
While these drugs are life-saving, it may have side effects that could weaken the heart muscles. Dr Yaranov explains that drugs like doxorubicin or trastuzumab could also affect how well the heart pumps blood, which can lead to ardiomyopathy or heart failure.
Because of this, many cancer centres now include routine heart monitoring before, during, and after chemotherapy. The goal is to fight cancer without compromising long-term heart health.
Stimulants that contain amphetamines help improve focus and alertness, but Dr. Yaranov warns that they can also:
Elevate the risk of heart attack in people who have underlying heart issues
He stresses that misuse or unsupervised use is especially dangerous. Even for those who take them as prescribed, regular follow-ups with a doctor are important.
Managing diabetes could mean being on medicines for lifelong. Yaranov points out that older drugs like rosiglitazone can increase the risk of heart failure despite effectively lowering blood sugar. Because of these concerns, many doctors now prefer newer diabetes medications that also support cardiovascular health. However, patients should never switch or stop medicines without medical guidance.
Thanks to allergens and climate change, common cold now stays all around the year, which means you will be taking cold medicines frequently and for a longer stretch. These medicines contain pseudoephedrine that work by narrowing blood vessels to relieve nasal congestion, however, Dr Yaranov says that they can also:
For individuals with hypertension or heart disease, Dr. Yaranov advises avoiding these drugs or using them only after consulting a healthcare provider.
Dr. Yaranov’s core message is simple: even routine medications have side effects worth understanding. Being informed helps people protect their cardiovascular health, especially if they already have heart risk factors. The goal is not to avoid necessary treatment but to use medicines wisely and stay in regular touch with your doctor.
Note: This article is based purely on the remarks shared by Dr. Dmitry Yaranov. Health and Me does not recommend discontinuing or changing any medication without first consulting your doctor.
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"Did I do a good job? Do you think Biden could have done this? I don't think so," said President Donald Trump to the reporters assembled at the Oval Office after he made the announcement that he had secured a deal to slash the price of obesity drugs. His website, TrumpRx, will offer the sale of drugs like Wegovy and Zepbound, for only around $250 a month, which is a fraction of their current retail price which is more than $1,000.
While it is a breakthrough, as many private insurances do not cover obesity drugs, and often forces people to pay for these injections out of pocket, experts point out that this system is not entirely flawless.
Drug policy experts say that while the administration has promised drugs at a cheaper rate, some of these discounts have not been approved yet by the Food and Drug Administration. The problem is that the lower prices for people paying out of pocket would only apply to the lowest doses of the drugs, however, the deal does not expand Medicare coverage to people seeking treatment for weight loss alone.
Juliette Cubanski, who is the deputy director of Medicare policy program at KFF, said, and as is reported in NBC News, "It’s a situation where we have more questions than answers. Based on what we didn’t hear, that suggests to me that there’s a lot that the administration itself hasn’t even ironed out as of yet. It just feels a little bit too squishy right now."
Art Caplan, also reported in NBC News, who is the head of the division of medical ethics at NYU Grossman School of Medicine in New York City, said, "It’s just murky as to how this will take shape, how the programs will work. You can’t really tell from what’s going on.”
Several drugs and forms of drugs included in the deal are actually not approved by the FDA. These include oral versions of weight loss drugs, and Eli Lilly's new multidose injection pens. In fact, Lawrence Gostin, director of the O'Neill Institute for National and Global Health Law at Georgetown University said that the administration has made premature promises because the lower prices cannot take effect until the products are on the market. "It is reckless to negotiate pricing deals on products which the FDA have not yet approved as safe and effective. The administration is getting way out ahead of its own safety agency.”
While the White House did say that both the pills and injection pens will be available for discounted prices for those who pay out of pocket, policy makers say that they may end up paying more.
The starting doses of weight loss pill will cost $149 per month, and the shots will cost around $350 for a month's supply. The price of the injection is further expected to fall to about $259 within two years. However, when people start with the drugs, they start with the lowest dose that allows the body to get used to the drug, However, over the course of time, the dose increases to be effective for weight loss. For Wegovy, the highest doses are five, for Zepbound, it is six, and the most weight loss has seen with the highest doses.
Officials said the starting dose of GLP-1 pills will cost $149 per month, though they didn’t clarify pricing for higher doses.
For injections, the White House offered only a “weighted average” estimate of $350 a month. Lilly later specified that Zepbound will start at $299 for the lowest dose, rising to $449 for higher ones. Novo Nordisk didn’t confirm dose-based pricing and said it will share updated cost details in the coming weeks.
All of this means patients using TrumpRx could ultimately pay significantly more than the administration’s headline prices, especially since most people don’t remain on the lowest dose for long, Caplan noted.
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TV presenter Davina McCall revealed that she had breast cancer, almost a year after she had undergone a surgery to remove her brain tumor. In a video that she posted on her Instagram, she revealed that she was "very angry" when she found out the news, however, she is in a "much more positive place" after she has undergone another surgery three weeks ago to remove the tumor from her breast.
She said that she found a lump a few weeks ago, however, it came and went back, so she continued to do her work. "I found a lump a few weeks ago. It came and went but then I was working on The Masked Singer and Lorraine, the TV show, and Lorraine Kelly had put signs on the backs of all the doors saying 'check your breasts' and every time I went for a wee, I did that," she said.
She continued: "It was still there, and then one morning I saw myself in the mirror and thought 'I'm going to get that looked at'. I had a biopsy. I found out it was indeed breast cancer and I had it taken out in a lumpectomy nearly three weeks ago."
McCall, who is now 58, says that the lump was "very, very small" and was discovered at an early stage. "I am so relieved to have had it removed and to know that it hasn't spread. My lymph nodes were clear, I didn't have any removed, and all I'm going to do now is have five days of radiotherapy in January as kind of an insurance policy," she said.
"It's been a lot. I was very angry when I found out, but I let go of that, and I feel in a much more positive place now. "I think my message is: get checked if you're worried. Check yourself regularly. If you are due a mammogram, then get it done," she said.
She also revealed that it was only in August that she got her mammogram done, however, she has dense breasts, and so nothing was detected. "I have dense breasts and I had a mammogram in August, and I was postponing the ultrasound; I just couldn't find time to do it. Don't do that. Get the ultrasound."
Breast Ultrasound: A breast ultrasound uses sound waves that reflect off the breast tissue to create detailed images of the breast. There is no radiation involved.
Mammogram: A mammogram is an X-ray of the breast. A mammogram is an X-ray of the breast. A diagnostic mammogram focuses more closely on the area(s) of concern. We will get more X-ray views of the concerning area. We perform a diagnostic mammogram any time a patient comes in with symptoms of breast cancer or after an abnormal screening mammogram.
As per the MD Anderson Cancer Center, normal breast tissue and cancerous tissue, both appear white on a mammogram, this is when an ultrasound can help us see small cancers that may be hiding amongst normal breast tissue. This is especially true for women with dense breasts, which means they have more glandular tissue and less fat in their breasts.
However, the MD Anderson Cancer Center mentions that ultrasound is not recommended as a replacement for a mammogram. "Screening mammograms detect about 4 to 6 cases of breast cancer per 1,000 women. When a breast ultrasound is done on top of that, we detect about 2 to 3 more cases. So, breast ultrasound is a valuable screening tool we use in addition to a mammogram," it notes.
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