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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Persistent back pain in young adults is often dismissed as poor posture, long hours at a desk, or muscle strain. But doctors are warning that in some cases, it could be a sign of ankylosing spondylitis — a chronic inflammatory autoimmune disease that affects the spine and can silently progress for years before diagnosis.
In India, 16.5 lakh people suffer from the condition, with an average diagnostic gap of nearly seven years from the time symptoms first appear. During that window, the disease continues to silently progress, and the burden is far from small.
“Ankylosing Spondylitis is one of the most underdiagnosed conditions we encounter in clinical practice, and the consequences of that delay are real,” Dr. Arvind Mehra, Senior Director and HOD - Orthopaedics at Paras Health Gurugram, told HealthandMe.
Moreover, “It takes several years of pain and stiffness before people seek treatment, and by then, the diagnosis comes too late, and there has already been damage to the spine,” added Dr. Ashish Tomar, Director - Orthopaedics & Minimally Invasive Spine Surgery at Sarvodaya Hospital, Faridabad.
Ankylosing spondylitis, also known as axial spondyloarthritis, is a type of arthritis that primarily targets the spine but can also affect other joints. The term “ankylosing” means stiff or rigid, “spondyl” refers to the spine, and “itis” indicates inflammation.
The inflammatory disease causes some of the bones in the spine to fuse over time. This fusing not only makes the spine less flexible but can also cause issues while breathing.
Ankylosing spondylitis leads to inflammation in the spine and large joints, causing stiffness and pain. It can also impact the joint between the spine and the hipbone, potentially resulting in additional symptoms such as digestive issues, rashes, and weight loss.
What makes ankylosing spondylitis difficult to spot is that it often feels like ordinary back pain — but there are warning signs that set it apart.
According to experts, ankylosing spondylitis-related pain typically:
This pattern is very different from mechanical back pain, which usually worsens with movement and improves with rest.
Dr. Tomar told HealthandMe that ankylosing spondylitis is not simply a musculoskeletal problem — it is an autoimmune disease, where the body’s immune system mistakenly attacks healthy tissues, particularly around the spine and joints.
“Ankylosing spondylitis is not just another musculoskeletal disease. It requires the attention given to autoimmune disorders because it may affect the chest, hips, shoulders, and even the eyes, while also causing severe posture problems in advanced stages,” he said.
Beyond the spine, the disease may affect:
Who Is At Most Risk? How To Treat?
Young adults, typically in their twenties, are more likely to experience this condition because people often overlook its existence or mistakenly identify it as something else.
The combination of early diagnosis, structured physiotherapy, and suitable medications allows for effective disease progression control.
“When a young adult presents with inflammatory back pain, especially in the gluteal area, that persists beyond three months, the reflex should not be to prescribe a painkiller and wait. It should be investigated further. That shift in approach can make an extraordinary difference to someone’s long-term quality of life,” Dr. Tomar said.
Common treatments for ankylosing spondylitis include:
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When women are in their 40s, their bodies start to change a lot because of the hormones. This is mainly because the estrogen and progesterone levels in the body start to go down. This time is called Perimenopause.
It is when women start to move towards menopause. It can bring a lot of emotional changes. Some of these changes are normal.
After 40, women's bodies start to produce estrogen. This means they can have an imbalance.
Women's bodies need hormones like estrogen and progesterone to have periods, strong bones, a good mood, and to stay at a healthy weight. When these hormone levels change, it affects parts of the body. This change can take a year before it stops at menopause.
Common hormonal changes women experience
While some changes are normal, some symptoms need a doctor's help:
When women are over 40 and their hormones change, they are more likely to have:
Estrogen helps keep the heart and bones healthy, so when its levels go down, women are more likely to have these health problems."
Women should talk about these changes openly. If they know what is happening and see a doctor early, they can make this time easier.
Hormonal changes after 40 are a part of getting older, but women should not ignore them. Especially if the symptoms are very bad or happen all the time.
If women understand what is happening in their bodies and see a doctor when they need to, they can be healthier and more confident. If women take care of themselves now, they can have a life in the years to come.
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The US Food and Drug Administration (FDA) has approved tradipitant to be sold under the brand name Nereus, for the prevention of vomiting induced by motion in adults — a first in the last four decades.
Motion sickness affects an estimated 65 to 78 million Americans—roughly 25 to 30 percent of adults—during everyday travel by car, plane, or boat. For decades, patients have had no meaningful new treatment options.
Tradipitant is an oral neurokinin-1 (NK-1) receptor antagonist that prevents motion-induced vomiting in adults.
It is an oral capsule, often taken 60 minutes before travel to block signals causing nausea.
The drug by Vanda Pharmaceuticals is now commercially available across the US.
"Today marks an important milestone for the tens of millions of Americans who experience motion sickness symptoms during common travel," said Mihael H. Polymeropoulos, M.D, President, CEO, and Chairman of Vanda, in a statement.
Motion sickness occurs when the brain receives conflicting signals from the eyes, inner ear, and body while in motion. This sensory mismatch is believed to trigger the release of substance P, which activates NK-1 receptors in the central nervous system and ultimately leads to nausea and vomiting.
Tradipitant works by blocking these receptors, interrupting the vomiting pathway.
"NEREUS is a selective, high-affinity antagonist of human substance P/neurokinin-1 (NK-1) receptors that can block the vomiting center of the brain,” Polymeropoulos said.
Tradipitant was approved by the FDA, following two pivotal Phase 3 clinical trials—Motion Syros and Motion Serifos—conducted under real-world conditions on the open sea.
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Both studies demonstrated that tradipitant significantly prevents vomiting compared to placebo, confirming the drug's effectiveness in actual sea travel conditions. It is the first new prescription option for people with a history of motion sickness in over 40 years.
It employs a novel mechanism as a selective, high-affinity antagonist of human substance P/NK-1 receptors. It offers simple dosing with just one or two capsules a day taken approximately an hour before travel.
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According to Vanda Pharmaceuticals, tradipitant may impair abilities required for driving a motor vehicle or operating heavy machinery.
Combining tradipitant with sedatives or medications that increase the drug's levels may increase this effect. If use together cannot be avoided, your doctor may warn against driving or operating heavy machinery.
The most common side effects associated with tradipitant include drowsiness, headache, and fatigue.
Moreover, strong CYP3A4 inhibitors may increase NEREUS™ levels and the risk of side effects, the company said.
There are limited data on tradipitant's use in pregnant women and children.
Tradipitant is also not recommended in patients with liver problems or severe kidney problems.
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