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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Lung cancer has long been associated with smoking, but this is no longer the complete picture. While tobacco remains the leading cause, an increasing number of people who have never smoked are also being diagnosed with the disease. This changing pattern highlights the need to look beyond smoking alone when considering lung cancer risk.
In non-smokers, lung cancer is often diagnosed later because neither patients nor families may initially suspect the disease. As a result, symptoms are sometimes mistaken for common respiratory illnesses, delaying evaluation and treatment.
While smoking continues to account for most lung cancer cases, several other factors can also contribute. Long-term exposure to second-hand smoke, air pollution, radon gas, asbestos, diesel exhaust, and certain workplace chemicals has been linked to an increased risk. A family history of lung cancer or specific genetic mutations may also make some individuals more susceptible, even if they have never used tobacco.
In urban areas, prolonged exposure to polluted air is becoming an important concern. Fine particulate matter can enter deep into the lungs, causing long-term inflammation and damage that may increase the risk of developing lung disease, including cancer.
Early lung cancer may not cause noticeable symptoms. When symptoms do appear, they should not be ignored, particularly if they persist for more than a few weeks. Symptoms that should be evaluated by a doctor include:
• A persistent cough that does not improve
• Coughing up blood
• Chest pain
• Shortness of breath
• Unexplained weight loss
• Repeated chest infections
• Hoarseness of voice
• Persistent fatigue
These symptoms can occur due to several conditions and do not always indicate lung cancer. However, persistent or worsening symptoms should be assessed promptly to identify the underlying cause and begin appropriate treatment if needed.
Finding lung cancer at an early stage improves the chances of successful treatment. Individuals with prolonged exposure to environmental or occupational risk factors, or those with a strong family history of lung cancer, should discuss their risk with a doctor. Imaging tests such as chest CT scans and, when indicated, molecular testing help identify the type of lung cancer and support treatment planning.
Not every case of lung cancer can be prevented, but reducing exposure to tobacco smoke, avoiding harmful occupational exposures, improving indoor air quality where possible, and seeking medical advice for persistent respiratory symptoms can help protect lung health. Greater awareness that lung cancer can affect both smokers and non-smokers may lead to earlier diagnosis, timely treatment, and better outcomes.
(Dr Dipanjan Panda, Senior Consultant, Medical Oncology, Indraprastha Apollo Hospital, Delhi)
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Influenza strain H1N1, formerly known as swine flu, is rising significantly in India, with deaths also being reported in some states.
H1N1 is a subtype of Influenza A and can cause sudden fever, cough, sore throat, headache, body aches and fatigue. These symptoms can overlap with those of other seasonal influenza strains, COVID-19 and respiratory syncytial virus (RSV), making it difficult to identify the infection based on symptoms alone.
Delhi: According to official data, Delhi has reported 1,349 confirmed H1N1 infections. No official deaths have been reported.
Kerala: A total of 2,468 influenza cases were recorded in the state in July, with 24 deaths reported during the month. The total number of cases recorded in the state this year stands at 5,519, with 60 deaths reported.
Maharashtra: The state has reported 25 laboratory-confirmed H1N1 cases, including a major spike of 15 cases in July. One confirmed death was officially verified by the Nagpur Municipal Corporation (NMC) Death Audit Committee.
Gujarat: H1N1 activity is also being reported, with Ahmedabad currently seeing a rise in cases.
Although H1N1 influenza primarily affects the respiratory tract, the infection can also put additional strain on the heart in some people, particularly those with a chronic history of cardiovascular disease, experts told HealthandMe.
Fever, dehydration, increased levels of carbon dioxide in the body, decreased oxygen levels and the body’s inflammatory response can increase the workload on the heart during an H1N1 infection.
This added strain may be more concerning for people who already have cardiovascular disease, said Dr. Praveen Raman Mishra, Associate Consultant, Institute of Cardiac Sciences at ShardaCare – Healthcity.
Some H1N1 influenza patients may experience cardiovascular complications, including:
Dr. Saurabh Gupta, Associate Director, Internal Medicine, Yashoda Medicity, added that H1N1 infection may cause fluctuations in heart rhythm or inflammation associated with the heart.
“In some circumstances when suffering from the H1N1 virus, although the initial symptoms of the virus may be those shared with the normal flu, such as temperature, aches and cough, those with pre-existing heart conditions should be more vigilant whilst they’re recuperating,” he told HealthandMe.
“As the infection puts more work on the body, you can find that previous heart problems are more noticeable,” he added.
The experts noted that people recovering from H1N1 should seek medical attention if they develop symptoms such as:
People with a chronic history of cardiovascular disease may face greater strain on the heart during H1N1 infection.
Monitoring symptoms during recovery and seeking medical attention when concerning symptoms develop can help identify cardiovascular problems early.
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For many women, menopause can bring a string of uncomfortable symptoms like hot flashes, sleep problems, changing body composition and weight gain.
Now, researchers are looking at whether combining GLP-1-based weight-loss medicines with menopausal hormone therapy (MHT) could offer greater benefits, particularly for women struggling with obesity after menopause.
A recent Mayo Clinic study, published in The Lancet Obstetrics, Gynaecology & Women's Health, found that postmenopausal women taking tirzepatide along with hormone therapy lost about 35% more weight than those taking tirzepatide alone.
Researchers studied 120 postmenopausal women with overweight or obesity who had been taking tirzepatide for at least 12 months. Forty women were also using MHT, while 80 were not.
Women taking both treatments lost around 17-19% of their body weight, compared with about 14% among those taking tirzepatide alone. About 45% of women on the combination achieved at least 20% weight loss, compared with 18% in the tirzepatide-only group.
“This study provides important insights for developing more effective and personalized strategies for managing cardiometabolic risk in postmenopausal women,” said Dr Regina Castaneda, first author and Mayo Clinic researcher.
However, this was just an observation in the study, not a randomized clinical trial. Therefore, it cannot prove that hormone therapy itself caused the additional weight loss.
“It is possible that women using hormone therapy were already engaged in healthier behaviors, or that menopause symptom relief improved sleep and quality of life,” said Dr Maria Daniela Hurtado Andrade, senior author of the study.
Also read: Postmenopausal Women May Face More Severe Dry Eye Disease; How Do Hormones Contribute?
During menopause, declining oestrogen levels can change fat distribution, appetite, metabolism and muscle mass. GLP-1 medicines, meanwhile, reduce appetite and slow stomach emptying, helping with weight management.
Researchers believe there could also be a biological interaction between oestrogen and GLP-1 signalling. “Preclinical data suggest a potential synergy, with estrogen appearing to enhance the appetite-suppressing effects of GLP-1,” Castaneda said.
Earlier research has also suggested greater weight loss among postmenopausal women using semaglutide alongside hormone therapy.
A 2026 review similarly concluded that GLP-1 medicines may help reduce weight and abdominal fat in menopausal women, but larger studies are needed.
Also read: Experimental Menopause Drug Shows Promise Mid-Stage Trial, Reduces Hot Flashes By 83%
GLP-1 medicines may cause nausea, vomiting, diarrhoea, constipation, abdominal pain and reduced appetite. These effects often surface when the dose is increased.
Hormone therapy has its own side-effects and it is also not suitable for everyone. Depending on the patient's medical history, MHT can increase the risk of complications like blood clots and stroke.
Hormone therapy should not be started simply to fuel weight loss from a GLP-1 drug. It is primarily used to treat certain menopause symptoms and should be prescribed after considering a woman's age, symptoms, medical history and individual risks.
As Hurtado Andrade noted, researchers now want to determine whether the combination offers benefits beyond weight loss, including improvements in cardiometabolic health.
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