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.

A 30-year-old law student with Type 1 diabetes was hospitalized with diabetic ketoacidosis (DKA) after allegedly being advised to stop insulin while following the “VRK Diet” promoted by social media personality Veeramachineni Ramakrishna, popularly known as VRK.

According to the complaint, the student had been living with Type 1 diabetes since 2018. He alleged that he came across VRK’s social media videos claiming that the diet could permanently cure conditions including Type 1 diabetes, cancer and kidney disease.

The student later visited the VRK Health Care Centre in Hyderabad in September 2025, where he alleged that he was orally advised to stop taking insulin. He said he paid around ₹26,000 for supplements and services at the center.

Two days later, he was admitted to a private hospital with DKA and severe dehydration, according to the complaint. He was later discharged.

Hyderabad police have booked Ramakrishna and another person in an alleged fake-doctor and fraud case.

Why Type 1 Diabetes Patients Must Never Stop Insulin

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More than 9 million people worldwide are estimated to be living with Type 1 diabetes, including about 1.8 million children and adolescents.

Type 1 diabetes occurs when the body cannot produce insulin. Insulin helps glucose move from the blood into cells, where it is used for energy. People with Type 1 diabetes therefore need insulin to control their blood glucose.

“Insulin is not optional in Type 1 diabetes,” Dr Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, said in a post on X.

He advised people with Type 1 diabetes to never stop insulin on their own, including when they are unwell or unable to eat.

“Insulin doses may sometimes need adjustment, but this should be done with guidance from your diabetes team,” he said.

What Happens If Insulin Is Stopped?

The NHS UK explains that the human body needs insulin to break down glucose, i.e. sugar, to turn it into energy. People who have type 1 diabetes need insulin devices as their own body cannot produce it.

When the body does not have enough insulin, it cannot properly use glucose for energy. It starts breaking down fat instead, producing chemicals called ketones.

If ketones build up in the blood, they can cause diabetic ketoacidosis, a serious and potentially life-threatening complication.

DKA can develop when there is too little insulin, including when a person with Type 1 diabetes misses insulin doses.

Dr Kumar advised people with Type 1 diabetes to regularly monitor their blood glucose and check blood or urine ketones when indicated, particularly during illness or persistent high blood sugar.

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Warning Signs Of Diabetic Ketoacidosis

Dr Kumar said people with Type 1 diabetes should know the warning signs of DKA, including:

• Excessive thirst
• Frequent urination
• Nausea or vomiting
• Abdominal pain
• Dehydration
• Rapid or deep breathing
• Drowsiness or confusion

Anyone with symptoms suggestive of DKA should seek urgent medical care.

Can Diet Or Supplements Replace Insulin?

Type 1 diabetes is an incurable condition. Dr Kumar warned people to be extremely cautious about claims that Type 1 diabetes can be “cured” through supplements, diets, herbs or alternative treatments that allow insulin to be stopped.

“Check the qualifications and registration of anyone giving medical advice. Social-media popularity is NOT a substitute for medical training,” he said.

“One wrong piece of advice can have life-threatening consequences. For Type 1 diabetes, evidence-based medical care and uninterrupted access to insulin are essential,” he added.

Climate change is increasingly affecting human health, with the skin potentially among the first organs to show its effects, according to a new international study.

The analysis of 136 countries found that 42.6% reported climate-related changes in the prevalence, severity or both of skin diseases.

Presented at the European Academy of Dermatology and Venereology (EADV) Congress 2026, the study found that lower-income countries reported a greater burden.

Lower-Income Countries Report Greater Impact

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More than half of low-income countries (55.6%) and lower-middle-income countries (52.5%) reported climate-related changes in skin disease.

This compared with 43.8% of upper-middle-income and 28.3% of high-income countries.

Regional differences were also substantial:

• Western Pacific: 64.7%
• Eastern Mediterranean: 60%
• South-East Asia: 60%
• Europe: 16.1%

In Africa, 42.9% of respondents were unsure about climate change's impact on skin disease, suggesting gaps in surveillance and evidence.

Heat Rashes, Inflammatory Skin Diseases Rising

Among the 58 countries reporting climate-related effects, the most commonly reported changes included:

• Heat rashes: 81%
• Inflammatory skin diseases: 75.9%
• Infectious skin diseases: 62.1%
• Vector-borne diseases: 50%

“The most important finding from our study is that climate change is already associated with negative impacts on skin disease, and these effects disproportionately burden lower-income settings,” said Dr. Esther Freeman, study author and Associate Professor of Dermatology at Harvard Medical School.

How Climate Change Affects Skin

Read More: World Environment Day 2026: How Climate Change Is Increasing the Global Disease Burden | Explained

Rising temperatures, humidity, changing rainfall, air pollution and other environmental exposures can influence both the onset and severity of skin conditions.

Freeman said higher temperatures and humidity can increase sweating and skin irritation, while heat and air pollution may trigger or worsen inflammation.

“Shifts in temperature and rainfall can also affect the habitats of mosquitoes, ticks and other disease vectors, potentially allowing them to survive in places where they were previously uncommon,” she added.

Why Lower-Income Countries Face Greater Risks

The findings point to a wider climate-health disparity. Countries with fewer resources reported more climate-related changes in skin disease, despite generally contributing less to climate change.

These countries may also have fewer resources for disease surveillance, healthcare and climate adaptation.

The researchers called for stronger monitoring, greater awareness among healthcare professionals and locally tailored strategies.

Extreme Weather Can Trigger Skin Problems

The skin is constantly exposed to environmental conditions, making it particularly vulnerable to extreme weather events like flooding, wildfire smoke, etc.

• Flooding: It can increase traumatic injuries and bacterial or fungal infections, while contaminated water can trigger contact dermatitis.
• Wildfire smoke: Smoke and air pollution can worsen skin inflammation, including eczema.
• Heat waves: Prolonged exposure can aggravate inflammatory skin conditions and, in severe cases, contribute to heat exhaustion and heat stroke.
• Hot and humid weather: These conditions may increase some bacterial, fungal and viral infections.

As climate patterns change, the researchers said stronger surveillance and greater awareness of these emerging skin-health risks will be increasingly important.

Freeman stressed the need “to start treating skin health as part of climate-health preparedness.”

Key priorities include:

• Strengthening surveillance
• Improving climate-health education
• Developing locally relevant adaptation strategies
• Accounting for differences in healthcare resources.

Diabetes at 35 and diabetes at 60 are not the same. As we grow older, the way diabetes presents, the complications we worry about and even the way we treat it can change. This is why diabetes care after 60 needs to look beyond a single blood test.

HbA1c remains an important measure of average blood sugar over the previous few months. But for an older adult, it cannot be the only measure of good diabetes care.

Diabetes Symptoms Can Be Silent in Older Adults

One of the challenges with diabetes in older people is that symptoms may not always be obvious. A person may not experience the typical excessive thirst, frequent urination or unexplained weight loss, even when blood sugar levels are high.

At the same time, older adults can be more vulnerable to diabetes-related complications affecting the eyes, kidneys, nerves, heart and blood vessels. Vision problems are particularly important because loss of vision can directly affect mobility, confidence and independence.

This makes regular screening essential, even when a person feels completely well.

The Same HbA1c Target Does Not Suit Everyone

There is no single HbA1c cut-off that is appropriate for every older adult. Treatment goals need to consider age, overall health, cognitive function, physical function, existing complications and the person's ability to manage treatment independently. Current diabetes standards specifically recommend individualising glycaemic goals in older adults.

For example, a healthy 65-year-old who is active and independent may have very different treatment goals from an 80-year-old who is frail, has multiple medical conditions or needs help with daily activities.

The goal should be good blood sugar control without causing unnecessary harm, particularly hypoglycaemia.

Treatment After 60 May Need to Be Different

As people age, kidney function can change, meals may become irregular and multiple medicines may be prescribed for different conditions. These factors can increase the risk of low blood sugar and make complex treatment plans harder to follow.

Therefore, doctors may need to review medicines regularly and simplify treatment when appropriate. The focus should be on finding a treatment plan that is effective, safe and practical for that individual.

Look Beyond Blood Sugar

A comprehensive diabetes review in an older adult should also consider:

• Eye and retinal health
• Kidney function
• Blood pressure and cholesterol
• Foot and nerve health
• Risk of hypoglycaemia
• Nutrition and unintended weight loss
• Muscle strength and mobility
• Memory and cognitive function
• Risk of falls
• Ability to take medicines and manage diabetes independently

The aim is not simply to produce a better HbA1c report. It is to prevent complications while helping the person remain active and independent.

Nutrition and Exercise Should Protect Independence

Older adults with diabetes need adequate nutrition, particularly protein and other nutrients needed to maintain muscle mass. Excessive dietary restriction can sometimes do more harm than good.

Physical activity is equally important. Walking, strength exercises and balance activities, when medically appropriate, can help maintain mobility and reduce the risk of losing independence.

Growing Older Well With Diabetes

Diabetes management after 60 should be personalised and regularly reassessed. What is appropriate at 60 may not be appropriate at 75 or 85.

As we mark the International Day of Older Persons, the message is simple: living well with diabetes in later life is about much more than achieving a particular HbA1c.

We need to treat the person, not just the number — protecting their health, safety, dignity and independence as they grow older.

By Dr. Uthra S, Senior Consultant, Dr. Mohan’s Diabetes Specialties Centre