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.
Credit: Canva
In a shocking case highlighting delayed diagnosis, a UK-based man visited doctors 24 times in a year for persistent back and leg pain but was repeatedly dismissed. He died just 12 days after being diagnosed with cancer.
The symptoms of 61-year-old Nigel began with lower back and leg pain. As the cancer spread across his body, he suffered from indigestion and severe weight loss. His doctors ignored his symptoms and could not even pinpoint the exact cancer till his death.
It was only a week after his death that the doctors were able to find that Nigel had pancreatic cancer — a type of cancer that often goes undiagnosed due to a lack of early detection tests, said his wife, Liv Williams, writing in an essay for Metro.co.uk.
“Nigel saw a healthcare professional 24 times, and even then, we didn't know it was pancreatic cancer. If something like the breath test had been available, maybe Nigel could have had treatment to give him more time with us,” Liv explained.
Also read: Former US Senator Ben Sasse Opens Up About Battle With Terminal Stage 4 Pancreatic Cancer
Nigel, a father of three, began experiencing lower back and leg pain in early 2023. Liv said that his primary care doctor referred him to a physiotherapist, but the wait took months and his condition worsened. He also developed serious indigestion.
“From March to June, Nigel sought medical advice, and each time he was sent away, either empty-handed or with medication for pain or indigestion,” she said.
Thinking the pain must be related to a spinal issue, the family paid out-of-pocket for an MRI. The lumbar spine MRI scan revealed nothing.
"But what is it then?, we asked in frustration numerous times; always to be told it would get better on its own," Liv wrote in the essay.
By July, Nigel could not stand the pain, and Liv was forced to take him to the Emergency Room (ER).
“His painful leg was getting thinner and thinner, like it was wasting away, and the pain was unbearable,” she said. Nigel lost significant weight, struggled to eat, relied on crutches, and could not sleep due to constant pain.

“Just before Christmas, I demanded a blood test from his GP – but three weeks later, a few days before the scheduled tests, Nigel couldn't urinate, which left him in agony,” she added. A visit to the ER was unfruitful as they had to rush back due to his pain.
The next time they visited the hospital, Nigel "screamed with pain", and seeing this, "a nurse promptly set him up on a bed with an IV".
The next day, the doctors informed Liv that Nigel had cancer. But as it had metastasized so much that his doctors could not pinpoint the exact cancer.
In just 12 days on February 9, 2024, Nigel died surrounded by his family.
What Is Pancreatic Cancer? Know The Warning Signs
Pancreatic cancer has long been one of the toughest challenges in oncology. With a five-year survival rate hovering around 13 percent and recurrence rates approaching 80 percent after treatment, the odds have historically been stacked against patients.
The prevention and early detection remain vital.
Experts warn that pancreatic cancer often masquerades as common ailments, delaying diagnosis. Here are some early symptoms that should never be ignored:
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Kidneys are extraordinary organs that perform critical tasks on a continual basis, e.g., filtering out waste, keeping electrolytes balanced, controlling blood pressure, and providing metabolic stability.
However, many people don’t pay enough attention to keeping their kidneys healthy until they discover that substantial damage has already happened.
Some of the most prevalent and underestimated threats to kidney functioning include uncontrolled blood pressure, chronic anxiety, and unhealthy living.
Hypertension (high blood pressure) is considered one of the most prevalent causes of CKD (chronic kidney disease) worldwide.
The kidneys need the support of a complicated design of tiny blood vessels to carry out their task of removing waste from the bloodstream. An ongoing and increased blood pressure level will slowly harm these small blood vessels by reducing their ability to function normally. As time passes, this injury will result in scar formation of the kidney tissue, causing a continual decline in the kidney’s ability to filter.
Hypertension is known as a silent killer because it frequently has no symptoms for many years. By the time someone experiences symptoms of high blood pressure, their kidneys may have already been damaged for a considerable period.
Chronic stress is often overlooked as an indirect cause of kidney damage. When we are under chronic stress, our sympathetic nervous system is activated, and the amount of stress hormones (cortisol and adrenaline) in our bodies increases.
These physiological changes lead to prolonged increases in blood pressure and blood glucose; both of these risk factors are bad for our kidneys. Chronic stress may cause people to engage in unhealthy coping strategies like poor diet, smoking, consuming alcohol, or not being physically active, which also increases their risk of kidney damage.
Our long-term kidney function is largely determined by lifestyle choices, including our dietary habits. Diets high in sodium, processed foods, and unhealthy fats increase the probability that you will develop hypertension, metabolic disorders, or some combination of both of these, which puts even more strain on your kidneys.
The sedentary lifestyle associated with obesity, insulin resistance, and cardiovascular disease are all significant contributors to chronic kidney disease. Dehydration, taking large amounts of over-the-counter medications (especially NSAIDs), and using tobacco products are all additional risk factors for progressive loss of kidney function.
Many of these risk factors can be addressed through prevention.
Regular monitoring of blood pressure, using mindfulness and other methods to manage stress levels, and maintaining a healthy diet full of fruits, vegetables, and whole grains will all help to reduce the strain on your kidneys.
Regular health screenings for people who have some of the above-mentioned risk factors (e.g., diabetes, high blood pressure, etc.) will give people an opportunity to identify problems early, giving them time to adjust their lifestyle or possibly seek some other type of treatment (e.g., taking medication).
Gaining and maintaining awareness of what contributes to the health of the kidneys can help protect the kidneys.
Gaining awareness of and taking action against hidden risks, such as high blood pressure or chronic stress, and making positive changes to your lifestyle will help maintain kidney function and minimize the likelihood of developing long-term complications in the future.
Early intervention is the most effective method for protecting the health of your kidneys.
Credit: WHO
In my early years of clinical practice, it was not uncommon to see children admitted with severe measles, struggling with complications that could turn fatal.
Polio was not a chapter in textbooks—it was visible in outpatient clinics, in children who came in with permanent disabilities, and in families learning to cope with lifelong consequences.
Diarrheal diseases filled pediatric wards, often pushing already fragile children to the brink. These were not isolated cases; they were a pattern we saw far too often. What changed this reality was not a coincidence. It was vaccines.
Over the years, I have witnessed firsthand how immunization has transformed pediatric care in India. The introduction of the measles vaccine in 1985, followed by the second dose in 2010, has brought us to a point where a disease once feared by every parent is now on the verge of elimination.
Similarly, the impact of the Pulse Polio Immunization campaign has been extraordinary. From routinely seeing children affected by polio, we moved to a historic milestone—India being declared polio-free on March 17, 2014. For clinicians who have seen both sides, this shift is nothing short of remarkable.
The change has been equally significant in other areas. There was a time when severe diarrhea dominated pediatric admissions. Today, with better sanitation and the introduction of the rotavirus vaccine in 2016, we see far fewer cases of severe rotavirus-related illness. This is not just a statistic—it is reflected in fewer hospital admissions, less distress for families, and better outcomes for children.
More recently, during the COVID-19 pandemic, the importance of vaccines became evident on an unprecedented scale. As healthcare providers, we experienced the strain of the pandemic firsthand. The introduction of vaccines in January 2021 marked a turning point. It not only reduced the severity of illness but also brought a sense of control in an otherwise uncertain situation. The ability to protect lives at such a scale reaffirmed what medicine has known for decades—vaccines are among the most powerful tools we have.
Across diseases, across decades, and across generations, one truth remains consistent: vaccines save lives. However, despite these clear gains, we are now witnessing a concerning shift.
In recent years, vaccine hesitancy has started to emerge—even among well-informed populations. As a clinician, this is deeply concerning. When diseases become less visible, people begin to underestimate their impact. Questions arise, doubts increase, and misinformation often fills the gap.
The consequences of this are already visible globally. The re-emergence of measles in countries with strong healthcare systems is a clear warning.
As per CDC data from March 18, 2026, the United States has reported 1,362 confirmed measles cases across 20 states, with multiple outbreaks—after more than two decades of control. This is not due to a lack of availability of vaccines, but due to reduced uptake.
From a medical standpoint, this is both predictable and preventable. Vaccination is not just about protecting one individual—it is about safeguarding entire communities. In my practice, I often remind families that immunization protects not only their child but also those who are more vulnerable—newborns, pregnant women, and individuals with weakened immunity. When vaccination rates decline, this collective protection weakens, and diseases find their way back.
History has shown us that progress in public health is not permanent unless it is sustained. The absence of disease does not mean the absence of risk—it often reflects the success of prevention.
The way forward is clear. We must continue to ensure timely immunization, strengthen awareness, and address concerns with clarity and empathy. As healthcare providers, it is our responsibility to build trust and provide evidence-based guidance. As a community, it is equally important to rely on science and not misinformation.
Vaccines have already proven their value—both in data and in daily clinical practice. The science is robust, the outcomes are visible, and the impact is undeniable. The question is no longer whether vaccines work. The question is whether we will continue to trust and use them.
Because the cost of inaction is not theoretical—it is seen in preventable illness, avoidable hospitalizations, and lives that could have been saved. For every generation, vaccines have worked. It is now our responsibility to ensure they continue to.
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