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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A uterine growth diagnosis can be very alarming. That said, it is vital to note that such growths are often simple, run-of-the-mill fibroids. They are non-cancerous, very common, and completely harmless. At the same time, it is important to realise what uterine sarcoma is, and why fibroids are often confused with uterine sarcoma. It comes down to anatomy. The uterus consists mainly of smooth muscle tissue. A fibroid is just an overgrowth of this smooth muscle that expands over time. Uterine sarcoma is a rare cancer that originates within that very same muscle wall. Since both develop in the same spot, they tend to trigger identical symptoms—like unexpected bleeding, pelvic aching, or pressure.
Before starting treatment, it is important to fully understand what the diagnosis is, as that is the first step to safety.
Surgeons often treat routine fibroids with minimally invasive techniques. These methods break or chop the tissue into smaller fragments so it can be pulled through tiny incisions. If a growth, however, turns out to be an unsuspected sarcoma, breaking it apart inside the pelvis can spread malignant cells. A thorough diagnostic workup beforehand makes sure nothing gets disrupted accidentally, so that the surgical team builds the safest possible treatment plan.
Here is some genuine peace of mind: benign fibroids don't suddenly turn into cancer. Medical research shows that malignant transformation inside an existing fibroid is exceptionally rare. Because fibroids and sarcomas are biologically different conditions from the start, monitoring a standard fibroid does not put you at risk of it turning into a tumor down the line.
Most fibroids stay completely harmless throughout life. It is, however, important to watch out for a few specific red flags:
Post-menopause changes: Fibroids shrink on their own once hormone levels drop after menopause. Any new growth or spotting at this stage demands a closer look.
Growths that keep expanding on medication: If a mass gets bigger while one is on prescriptions designed to shrink it, the patient must seek out a secondary review.
Ambiguous scans: When a routine ultrasound shows atypical tissue structure, stepping up to advanced imaging helps clear up the picture.
Following an ultrasound, it is recommended to opt for a dedicated pelvic MRI for a much sharper view of the uterine muscle wall to confirm whether a mass is truly benign.
Getting a second opinion from a specialist is a normal, proactive move. It is especially critical if:
The good news is that uterine sarcomas are remarkably rare, making up just 2% to 5% of all uterine cancers. A patient needs to be cognizant by paying attention to changes in the body and asking questions about the scans.
Dr Bindhu KS - Sr. Consultant Obstetrics, Gynaecology & Robotic Surgery, Apollo Hospitals Navi Mumbai
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For many women, polycystic ovary syndrome (PCOS) begins with a familiar story—irregular periods, acne, unwanted hair growth or difficulty conceiving. But PCOS is far more than a reproductive disorder. At its core, it is often a complex interplay between metabolism, hormones and reproductive health.
One of the most important, yet frequently overlooked, pieces of this puzzle is insulin resistance. When the body becomes less responsive to insulin, the pancreas compensates by producing more.
Elevated insulin levels can, in turn, contribute to increased androgen production by the ovaries and disrupt the delicate hormonal signals required for regular ovulation. The result may be irregular cycles, fewer ovulations and, for some women, difficulty becoming pregnant.
PCOS And Insulin Resistance Can Affect Women Of Any Weight
Importantly, PCOS and insulin resistance are not synonymous with obesity. Women with a healthy body weight can also have significant metabolic abnormalities. This is why judging metabolic health by appearance alone can be misleading.
The 2023 International Evidence-based PCOS Guideline recognises insulin resistance as an important underlying feature and recommends attention to metabolic risk across the weight spectrum.
Also read: Decoding The Fertility Markers
The Metabolic Risks Go Beyond Fertility
The metabolic implications extend well beyond fertility. Women with PCOS have a higher risk of impaired glucose tolerance and type 2 diabetes, making long-term metabolic surveillance an important part of care.
The guideline recommends appropriate glycaemic assessment, particularly when pregnancy is being planned or fertility treatment is being considered.
Also read: Can Regular Consumption of Junk and Processed Food Affect Fertility?
Building A Healthier Foundation For Pregnancy
Yet there is an equally important message of hope: PCOS does not mean infertility, nor does it have to define a woman’s health journey. Lifestyle interventions—including regular physical activity, nutritious eating, adequate sleep and sustainable weight management where appropriate—form the foundation of care and can improve metabolic health.
For a woman planning pregnancy, the goal should not simply be to “get pregnant.” It should be to enter pregnancy metabolically and emotionally healthier, with blood sugar, blood pressure, nutrition, lifestyle and other risk factors appropriately addressed.
Take-home message: PCOS is not merely about irregular periods or cysts on the ovaries. It is a lifelong condition in which metabolic health and reproductive health are deeply connected. Recognising insulin resistance early, looking beyond weight, and providing personalised care can help women protect both their fertility today and their health for years to come.
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The view generally is that the occurrence of knee issues is usually associated with age, injury or overexertion. However, there is another reason people ignore: lack of movement. If a person leads an inactive lifestyle, spending long hours sitting at a desk, working from the couch, watching TV or doing nothing physical, the eventual consequences for the knees might arise.
Knees are created for motion, and motion is essential for keeping the flexibility of a joint. Their effective functioning depends on the health of the muscles surrounding your knee. The less active various leg muscles are, including quadriceps and other counterparts, the weaker they will be. The muscles help stabilize the knee and can relieve it from some of the burdens during daily activities performed by the knees.
Remaining seated for an extended time can also lead to stiffness. When you sit for a while, you may feel uncomfortable or stiff in your knees when you finally stand up. While the occasional instance of stiffness may go away with movement, constant stiffness can impact mobility and cause people to wish to move even less.
Another issue is gaining weight. Living a sedentary lifestyle causes individuals to become heavier, and excess weight puts more stress on the knees. In time, this added pressure will lead to increased wear of the joints and the development of knee pain and other problems in the musculoskeletal system.
The positive aspect with respect to your knees is that you don’t have to put in hours at the gym to keep them safe. Small, steady efforts can easily do the trick. You can choose to walk for five minutes after being seated for a long time, stretch regularly, take stairs if you are physically able and do some simple workouts for the legs and thighs to increase strength. Low-impact sports such as swimming, cycling and walking can help you maintain muscle power and flexible joints while avoiding the stress on your knees resulting from extensive workouts.
Persistent pain in the knee, however, cannot be treated as a usual symptom of ageing. Knee swelling or prolonged stiffness, difficulties climbing stairs, instability, or pain that has an impact on routine activities should be addressed by health professionals.
Movement is necessary for knees to be strong and flexible. Therefore, if you want your knees to be strong, you need to use them consistently and perform all activities without remaining still for long.
(By Dr Sujoy Bhattacharjee, Chairman & Chief, Max Institute of Robotic Joint Replacement, Max Super Speciality Hospital, Saket)
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