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.

Semaglutide is the hero ingredient in the popular drugs Ozempic (used primarily to treat Type-2 diabetes) and Wegovy (used for chronic weight management).

Semaglutide, a GLP-1 receptor agonist, has shown its prowess in lowering the risk of heart attack, stroke, or death in patients with type 2 diabetes, obesity, and heart or blood vessel disease.

With emerging preclinical evidence suggesting its potential neuroprotective and anti-inflammatory effects, an international team of researchers from the US and Taiwan focused their study on semaglutide and patients whose cancer has spread to the brain.

Cancer in the brain, also known as brain metastases, is an advanced-stage (stage IV) cancer, which is generally associated with an increased risk of morbidity and mortality in patients. Those with comorbidities like type 2 diabetes are likely to have worse outcomes.

The research, published in JAMA Network Open, showed that although the once-weekly semaglutide injections cannot directly treat cancer, they can potentially help some very ill patients live longer.

“The findings of this cohort study suggest that GLP-1 RA use was associated with a significant reduction in all-cause mortality among patients with cancer with brain metastases and type 2 diabetes, with generally consistent association across subgroups," said the team from Albert Einstein College of Medicine in New York and National Cheng Kung University Hospital in Taiwan, in the paper.

How Semaglutide Helped Patients With Brain Metastases?

The teams analyzed medical records from 151 hospitals around the world.

They identified more than 19,000 patients with cancer, brain metastases, and type 2 diabetes. Of these, 866 had been treated with a GLP-1 drug, while over 11,000 had not.

Their final analysis included two groups of 850 patients who were compared for the effects of semaglutide and were followed for up to three years after their brain metastases were first recorded.

The patients taking semaglutide were significantly less likely to die -- about 37 percent -- during the follow-up period than those who were not.

The pattern was fairly consistent across several major cancer types, including lung cancer, breast cancer, and melanoma.

"These results build upon existing evidence that GLP-1 receptor activation modulates pathways relevant to neuro-oncologic health, including attenuation of neuroinflammation, preservation of blood–brain barrier integrity, and reduction of oxidative stress and mitochondrial dysfunction," the researchers said.

However, they also acknowledged limitations, such as the study was retrospectively conducted, which checked medical records and did not test patients in a controlled trial.

Ozempic Goes Generic, To Cost Less By 90%

With Novo Nordisk losing its patent in many countries, the sky-high prices of Ozempic and Wegovy are likely to go down by 90 percent.

This means the drug will be available at cheaper rates to 40 per cent of the world's population.

In India, the patent ended on March 20, and since then, several companies, including Alkem Laboratories, NATCO Pharma, Eris Lifesciences, Dr. Reddy’s Laboratories, Sun Pharmaceutical Industries, and Glenmark Pharmaceuticals, have launched their generic versions of semaglutide at a reduced price.

Also read: Semaglutide Becomes Cheap In India: A Gamechanger Or Health Gamble?

Who Should Avoid Semaglutide?

Semaglutide should be avoided or used with extreme caution in:

• Patients with a history of medullary thyroid carcinoma
• Individuals with a history of pancreatitis
• Those with severe gastrointestinal disease (e.g., gastroparesis)
• Pregnant or breastfeeding women
• Patients with Type 1 diabetes
• Patients with severe eye problems due to diabetes (can be taken with care)
• Individuals seeking purely cosmetic weight loss without a medical indication.

Living in more intensely developed neighborhoods may actually protect you against a stroke, a new University of Michigan study suggests.

Researchers tracked more than 25,000 adults across the US for over a decade and have now found that residents in areas with higher levels of development with more buildings, sidewalks and infrastructure, had a 2.5 percent lower risk of suffering a first-time stroke compared to residents in less developed areas.

Cathy Antonakos, research specialist senior in the U-M School of Kinesiology and first author explained: ""High-intensity development typically includes greater housing density and more commercial/retail outlets.

"These areas are more likely to feature compact land uses with access to health care, food stores, public transport and physical activity infrastructure like sidewalks, bike facilities and parks."

However, the study did not examine these environmental features, but there are some practical applications, Antonakos noted.

"For physicians, the study suggests that neighborhood-level factors may influence first-time stroke risk, in addition to individual-level factors," she said. "For planners, the findings suggest that enhancing environments with features that support cardiovascular health and physical activity may help lower the risk of first-time stroke."

Strokes: A Rising Crisis In India

Heart strokes are also one of the leading global health burdens, causing significant deaths and disability worldwide, including in India. Compared to Western countries, stroke also tends to occur at a younger age and is associated with a higher case fatality rate in the country.

One in seven stroke patients in India are young adults aged below 45 years, with hypertension leading as the major risk factor, according to a study by the Indian Council of Medical Research (ICMR).

The Global Burden of Disease Study 2021 identified hypertension, air pollution, tobacco smoking, high cholesterol, increased salt intake, and diabetes as the leading risk factors of stroke.

Incidence of stroke is increasing significantly in low- and middle-income countries (LMICs), especially in India, due to population growth, aging, and greater exposure to risk factors.

Wine Reduces Your Risk Of Strokes

A new global study suggests that moderately drinking wine can decrease your risk dying from cardiovascular disease by 21 percent.

A group of Chinese researchers who analyzed 340,924 adults in the UK between 2006 and 2022 classified a 12-ounce beer, a 5-ounce glass of wine or a 1.5-ounce shot of liquor each contains about 14 grams of pure alcohol.

Those who consumed less than 20 grams per week, about 1.5 standard drinks, were classified as never or occasional drinkers. The low alcohol consumption group included men who drank more than 20 grams per week but no more than 20 grams per day, and women who drank between 10 grams per day and 20 grams per week.

They found those with high alcohol consumption were 24 percent more likely to die from any cause, 36 percent more likely to die from cancer and 14 percent more likely to die from heart disease.

Additionally, even low intake of spirits such as beer or cider was associated with a nine percent higher risk of dying from cardiovascular disease compared with drinking never or occasionally.

Researchers at the University of California Riverside have developed a low-cost fake drug detector that can detect fake medicines by studying how pills dissolve in water.

Tested on 30+ medicines, the detector identified drugs with about 90 percent accuracy and could even distinguish between brand-name and generic versions.

William Grover, associate bioengineering professor at the University of California, Riverside explained: "Watered-down or illicit versions of drugs like Botox or popular GLP-1 inhibitors have caused serious injuries or death.

"The theory here is that if it's a legitimate medicine, the manufacturer made every pill identical enough that they'll all behave roughly the same way when they dissolve.

"So if you test a suspect pill, and it dissolves at a different rate than the real thing, this suggests the suspect pill is counterfeit."

Talking about the success of the device, Grover said: "We took Bayer aspirin pills and drug-store-brand aspirin - these are basically identical medicines with the same active ingredient and very similar inactive ingredients but when ran through our tests, we could easily tell the difference between the two products."

Costing as little as $5–$30, the device could help tackle the global issue of fake medicines, which the World Health Organization estimates affect 1 in 10 drugs worldwide.

How Does It Work?

The fake drug detector is essentially a low-cost infrared sensor made for use in toy robots able to follow lines drawn on paper. The researchers repurposed the sensors to instead track the rate at which pills dissolve in water.

All pills of a given drug dissolve or ideally should dissolve at roughly the same rate. Legitimate medications don't necessarily dissolve any faster or slower than counterfeit ones however since, the are made by different people at different facilities and with different ingredients, each drug's dissolution rates form a "fingerprint" that makes them identifiable and different from that of a fake drug.

What Else Can The Fake Drug Detector Be Used For?

Grover notes that he would like to use this method to detect fake antimalarial drugs as they are a major cause of death in many tropical regions. Malaria is treatable with the right medications.

"Unfortunately, bad actors know they can make money preying on the need for antimalarials. They sell pills that have the same packaging as authentic antimalarials, but don't contain the active ingredients. If someone gives these pills to their child, they won't cure their infection."

The expert also hopes to get his tool into the hands of those who can use it to fight fake antimalarials and other fake drugs.

"I can't imagine a more despicable person than someone who would sell fake medicine to a child. I hope our work makes those criminals' lives a little harder."