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.

From bone smashing to black market peptides, the modern push to “optimize” the male body increasingly runs through human endocrinology, often without a doctor anywhere in the loop.

A Trend That Outgrew Its Origins

Looksmaxxing began on incel forums that blamed romantic failure on fixed facial geometry. That ideology has since spread to TikTok and Instagram, stripped of some of its uglier language but keeping its core premise: a man’s body can and should be engineered, whatever the cost. What started as a fringe belief system now functions as mainstream influencer content with millions of followers.

Clinicians split the practice into softmaxing (sleep, skincare, fitness, mostly harmless) and hardmaxxing, which branches into two wings: mechanical (bone smashing, jaw implants, leg lengthening) and pharmaceutical (unsupervised testosterone, anabolic steroids, SARMs, and peptides marketed as growth hormone substitutes). The pharmaceutical wing is growing fastest, and it sits squarely in endocrinology’s territory.

What These Drugs Actually Do

The body regulates testosterone through a feedback loop running from the hypothalamus to the pituitary to the testes. Flood that system with outside testosterone or anabolic steroids, and it shuts down its own production, taking fertility down with it. SARMs were built to act on muscle and bone while sparing the prostate, but none are approved for human use, and the versions sold online are unregulated and inconsistently dosed. Peptides like ibutamoren (MK-677) stimulate the body’s own growth hormone release. The mechanism sounds gentler, but few have completed real clinical trials for the uses they are marketed for.

The Documented Harms

Anabolic steroids:

● Testicular atrophy and infertility from HPG axis suppression

● Gynecomastia, from testosterone converting to estrogen

● Hepatotoxicity, especially with oral forms

● Psychiatric effects at high doses, including mood instability

SARMs:

● Liver injury, including cholestatic jaundice in black market cases

● Dose-dependent suppression of natural testosterone production

● Elevated liver enzymes, reduced HDL cholesterol

Across the board:

● Elevated hematocrit, raising clotting risk if unmonitored

● Adrenal suppression and disruption of corticosteroid and DHEAS production: exogenous androgens interfere with the hypothalamic-pituitary-adrenal axis, blunting the adrenal gland’s output of cortisol and dehydroepiandrosterone sulphate (DHEAS). The result is impaired stress response, fatigue, and hormonal dysregulation that persists well after the substance is stopped.

● Elevated blood pressure and increased cardiac sympathetic drive: anabolic agents raise systolic pressure and heighten sympathetic nervous system activity in the heart, accelerating resting heart rate and increasing myocardial oxygen demand. Over time, this contributes to left ventricular hypertrophy and raises the risk of arrhythmia.

● Unreliable contents: labels rarely match what is actually in the product, and contamination or substitution is common enough that toxicology reports periodically turn up drugs users never intended to take.

The Mechanical Risks

Bone smashing has no basis in orthopedic science. Bone remodels under sustained load, not blunt trauma, which produces fractures, hematomas, and sometimes permanent damage. Cosmetic jaw implants and leg lengthening are legitimate procedures in the right clinical context, but carry the same surgical risks, infection, nerve damage, long recovery, without the medical justification that normally accompanies them.

The pharmaceutical track carries its own structural toll: supraphysiological androgen levels accelerate calcification in tendons and menisci, reducing their elasticity and load-bearing capacity. Meniscal and tendon calcinosis increases the risk of tears and joint instability, often in the absence of any acute injury. Athletes who stop using these compounds may find the damage is already done.

A related danger runs alongside both tracks. Some men adopt extreme dieting, dehydration, or fasting protocols purely to sharpen jaw and cheekbone definition before photos. The behavior carries the same physical risks as any restrictive eating disorder, yet it rarely gets recognized or treated as one, since it is framed online as discipline rather than disorder.

Why Now

Gallup polling found that roughly a quarter of young American men report frequent loneliness, a notably higher rate than young women. Online communities built around appearance fill that gap with something that looks like belonging, even though the content itself runs on comparison and self-criticism.

TikTok’s own data illustrate how fast the trend has moved: searches for bone smashing and related terms ran in the hundreds of thousands per day in early 2026 and climbed into the millions within a month, before the platform restricted the content. Marketing has kept pace too: one UK survey found nearly a third of 16 to 25-year-olds see SARM ads on social media weekly.

What Legitimate Treatment Looks Like

TRT for confirmed hypogonadism, diagnosed through repeat morning bloodwork and monitored over time, is genuinely effective medicine. That is a different undertaking entirely from a eugonadal man sourcing hormones or peptides online to chase a feeling, with no diagnosis and no monitoring. The same distinction applies to surgery: a qualified surgeon’s evaluation is not the same as a procedure booked off a forum recommendation.

The Bottom Line

None of this is an argument against fitness or grooming, and most softmaxxing is harmless. The danger lies in a narrower set of behaviors: fracturing healthy bone, importing unregulated hormones, chasing a standard that keeps moving regardless of what is achieved.

Endocrinologists studying this are not against masculinity or ambition about one’s appearance. They are arguing that hormonal systems deserve the same evidence-based caution as any other organ system, and that distinction matters more now that these behaviors are still treated as cultural curiosities rather than the clinical concerns they actually are. A blood test and a doctor’s judgment remain better tools than a forum thread and a vial of unknown origin.

The United Kingdom is facing constant heatwaves. So far, the nation has witnessed two heatwaves, while the natural temperature increases usually during late July and August, thus creating fear and the possibility of more and more temperature rises. As the country has been going through a weather roller-coaster since May, there was a huge area of high pressure, commonly explained as a 'heat dome'. This resulted in dry, very warm, and sunny weather in the island nation.

Notably, the temperature soared up to 35.1 °C in London during the month of May. The temperature in the UK has been on a rising trend over the past few years, and the first time it touches 40C in July 2022. And according to the experts at the Met Office, if global warming continues at its current pace, temperatures in the mid-forties could be a serious possibility for the UK by 2050.

The World Health Organization advises people to drink plenty of water, avoid going outdoors during the hottest hours of the day, wear loose and light-coloured clothing, and keep homes as cool as possible as temperatures continue to spike across many parts of the world.

Indians are used to living with intense summer heat, and over the years, people have developed simple yet effective ways to cope with it. Many prefer to finish outdoor work during the cooler hours of the morning or after sunset. Drinking plenty of water and traditional cooling beverages, seeking shade whenever possible, and keeping a close eye on elderly family members, young children, and people with existing health problems are all common practices during extended spells of extreme heat.

Also Read: Why Thousands Of Black Men In The UK Are Now Being Invited For Prostate Cancer Screening?

Hospitals Under Pressure Throughout Western Europe And Strict Restrictions

The worsening conditions have disrupted healthcare services, with media reports saying hospitals have had to postpone critical imaging scans after sensitive equipment overheated. Cities have also opened emergency cooling centers to protect vulnerable residents.

In Paris, authorities have announced temporary bans on public alcohol consumption and takeaway alcohol sales to ease pressure on hospitals. Public drinking will be prohibited from noon to 7 a.m. over the weekend, while takeaway alcohol sales will be banned between 6 p.m. and 7 a.m.

The extreme temperatures have also reached the sporting world. Formula 1's governing body, the FIA, has declared another "heat hazard" ahead of the Austrian Grand Prix weekend at Spielberg's Red Bull Ring, triggering additional measures to protect drivers, teams, and spectators.

The June 2026 heatwave has triggered red alerts across France, Spain, Italy, and the United Kingdom, and killed dozens of people.

How Does Heat Impact Health?

Health experts warn that prolonged exposure to extreme heat can have serious and sometimes fatal consequences, particularly for older adults and people with underlying medical conditions.

According to the WHO, extreme heat can overwhelm the body's ability to regulate temperature, increasing the risk of heat exhaustion and heatstroke. As the body works harder to cool itself, it places added strain on the heart and kidneys, potentially worsening chronic conditions such as cardiovascular, respiratory, mental health, and diabetes-related illnesses, and increasing the risk of acute kidney injury.

Although monsoon rains provide relief from the unbearable summer heat, they also increase the risk of infections, dehydration, and diseases that are transmitted through water and that can affect the functioning of your kidneys. Since kidneys play a crucial role in eliminating toxins from your body and maintaining fluid balance, kidney care during the monsoon season becomes necessary.

Stay Hydrated

Though it is cooler during monsoon rains, your body needs enough water to help the kidneys filter the toxins efficiently. Try drinking 2-3 liters of clean water daily, or according to the requirement advised by your doctor. Avoid drinking contaminated water, as it increases the risk of infections in the kidneys.

Eat Healthy and Fresh Food

Eat fresh and cooked food at home instead of junk food that might get contaminated during the monsoon rains. Include seasonal fruits, vegetables, whole grains, and healthy protein sources in your diet. Restrict the intake of excess salt, canned products, and sugar drinks.

Prevent Infections

The monsoon season is prone to UTIs that may eventually reach the kidneys if not treated on time. Keep your body clean, wear dry clothes, and never keep urine in your bladder for a prolonged period. In case you have burning sensations while passing urine, fever, or pain in your lower abdomen, do see a doctor.

Control Health Problems

Individuals suffering from diabetes, hypertension, or pre-existing kidney problems should take special care of themselves throughout the monsoon. They should be taking their medications, measuring their sugar and blood pressure levels, and undergoing regular medical examinations to avoid kidney diseases.

No Self-medication

Analgesics and other OTC medications can cause damage to the kidneys when consumed frequently and without consulting a doctor.

Conclusion

It does not take much effort to maintain the health of your kidneys during the monsoon season. Simple things such as staying well-hydrated, consuming hygienic food, preventing any infection, keeping control of existing illnesses, and taking no medicines unnecessarily will ensure that your kidneys continue to perform at their best. In case of any swelling, change in urine output, fever, or back pain, you must see a doctor right away. The importance of the kidneys is undeniable for your well-being.

(By Dr. Bhanu Mishra, a Consultant- Nephrologist at Fortis Hospital, Shalimar Bagh)