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.

When Andrea de Armas was diagnosed with breast cancer at 26, she was preparing for a future that looked very different from the one she was suddenly handed.

Along with surgery and chemotherapy, she had to make decisions about her fertility and adjust to the of long-term consequences from treatment.

Now 30 and cancer-free, the US woman is still taking hormone therapy. The treatment has put her into temporary menopause.

“I’m really lucky. I feel like I’m doing OK,” de Armas told CBS News. “It took me a little bit to kind of adjust. It wasn’t immediate; it took time. It took understanding the kind of changes my body was going through. But I’m able to live a pretty normal life for a 30-year-old.”

Andrea’s experience highlights a revealing challenge of breast cancer in younger women. Young women who survive breast cancer face a series of emotionally heavy decisions about menstrual cycles, fertility, sexual health and emotional well-being, and menopause that comes decades earlier than expected.

Effects Of Breast Cancer Treatment On Young Women

Also read: Why Peak Incidence For Breast Cancer In India Occurs Between Ages 40–50, Compared To 60–70 In The US & Europe

De Armas initially struggled to get her concerns taken seriously. She was eventually diagnosed with breast cancer in 2023 and discovered that she carried a genetic mutation associated with an increased risk of the disease.

She underwent a lumpectomy in June, followed by chemotherapy. She later had a bilateral mastectomy and reconstruction, scheduling treatment around her studies so she could continue her physician assistant programme.

“We worked together as a team,” said Dr. Cristina Lopez-Penalver, the surgical oncologist at Baptist Health's Herbert Wertheim Cancer Institute who treated her. “She was really not about ready to let this breast cancer get in her way.”

De Armas graduated as a physician assistant in 2025 and began working a month later. However, despite completing surgery and chemotherapy, she continues to take hormone therapy because of the characteristics of her cancer.

That medication has placed her in temporary menopause, a treatment-related effect that can be particularly difficult for younger women to navigate.

Early Menopause Due To Hormone Therapy

Also read: Breast Cancer: Know the Risks, Recognise the Signs & Get Checked

Menopause occurs when the ovaries stop releasing eggs and producing lower levels of hormones, particularly oestrogen.

Although natural menopause usually occurs in the late 40s or early 50s, some cancer treatments can bring on menopause much earlier.

According to the American College of Obstetricians and Gynecologists (ACOG), chemotherapy can damage the ovaries, causing periods to become irregular or stop altogether.

Hormone therapy can also block oestrogen's effects to help prevent hormone-sensitive breast cancer from returning.

Some women experience temporary ovarian suppression, in which medication switches off ovarian function during treatment.

Others may develop permanent ovarian damage and early menopause. The outcome depends on the treatment, the woman's age and her ovarian function before treatment. In de Armas' case, hormone therapy has brought on temporary menopause.

The transition can be more abrupt than natural menopause, leaving women with symptoms that affect daily life. Common effects include:

• Hot flashes and night sweats: Sudden waves of heat and sweating can disrupt sleep and daily activities.
• Sleep disturbances and mood changes: Hormonal changes may contribute to insomnia, irritability and low mood.
• Vaginal dryness and sexual discomfort: Reduced oestrogen can affect vaginal tissues and sexual health.
• Changes in fertility: Damage to ovarian function can reduce the chances of conceiving naturally, sometimes permanently.
• Bone health concerns: Low oestrogen levels can accelerate bone loss, increasing the risk of osteoporosis over time.

The National Cancer Institute notes that treatment-related ovarian insufficiency can also cause joint pain, reduced libido and difficulty concentrating.

Menopause is often characterised symptoms like by hot flashes and night sweats. But for some women, the transition can also bring changes in mood, memory and concentration that may be harder to identify. These symptoms can affect everyday life and may be misconstrued as stress, ageing or the emotional effects of children leaving home.

On World Menopause Day 2026, Dr. Abha Majumdar, gynaecologist and one of the lead IVF specialists in the country, told HealthandMe that women and their families need to identify the least obvious symptoms of perimenopause, the transition leading up to menopause.

Menopause Symptoms Dismissed For Empty Nest Syndrome

Empty nest syndrome refers to the feelings of grief, loneliness or loss of purpose that some parents experience when their children leave home to study, work or start their own families. The transition can bring changes to family routines and relationships, especially for parents who have spent years raising their children.

Dr Abha points out that mood changes in women during their 40s should not automatically be attributed to empty nest syndrome.

Perimenopause, the transition leading up to menopause, can also involve mood swings, forgetfulness and difficulty managing everyday tasks.

As she puts it, “Suddenly, around 45 or around that time, she starts feeling depressed. Everyone says, "Oh, children have grown up, you know, it is like an empty nest. But it is not just an empty nest.”

Recognising the symptom is key so that women experiencing new or persistent symptoms are not dismissed as simply struggling with their children leaving home, and can seek medical advice when needed.

Also read: World Menopause Day 2026: Perimenopause Can Begin In Your Late 30s. What Changes Should You Watch For?

Symptoms Not Related To Menstrual Cycle

Perimenopause can bring changes that don't relate to menstrual or hormonal cycle. Women may find themselves to be forgetful about routine things, struggle to concentrate or feel overwhelmed by tasks they previously managed with ease.

Dr Abha explains how these changes may appear in everyday life. She said, “She starts forgetting. She starts finding it difficult to cope with the daily chores which she did very easily before that.”

She says women may also face cognitive symptoms like brain fog and mood swings during this phase. She said, “Forgetfulness, cognition difficulties, brain fogging, mood swings.”

These symptoms can be confusing when women do not know that they come with menopausal transition. Changes in mood, for instance, may be misconstrued as reaction to family responsibilities, work stress or other pressures, while difficulties with memory and concentration may completely go unnoticed.

Also read: Menopause Abruptly Shifts Bones, Liver And Blood Fats, Study Finds

Perimenopause Duration

Perimenopause does not begin at the same age for everyone. Also, the transition may continue for several years before menopause sets in.

Dr Abha said that perimenopause may last for five or even 10 years before menopause sets in. She also said that fluctuating oestrogen levels are part of this phase.

“She's probably going through a perimenopause, which is it estrogen deprived and then comes up, goes down and comes up, and goes down and comes up. It may take couple of years for menopause to set in," she said.

Since the transition can be prolonged, understanding its symptoms is important for women as well as their families. Dr Abha explains that husbands and adult children should be attentive to changes in a woman's behaviour, mood or ability to manage familiar routines, rather than dismissing them.

She also stresses that women's health after menopause deserves attention, particularly as life expectancy increases.

She said, “Please support her at that time because she's got 25 years more to live right away. Maybe more.”

Medical Attention

Mood changes, fatigue, sweating and memory difficulties should not automatically be attributed to menopause. Other health issues can produce similar symptoms, which makes medical attention important.

Dr Abha advises women to seek help whenever they notice a change that makes everyday activities more difficult.

She said, “Any point. If she feels something is happening to her, she's not being able to cope with her daily chores. She used to cook so effortlessly, now it takes a lot of effort. She starts getting tired, she sweats. That is the time. May it be 40, may it be 45, may it be 38 also.”

A doctor can assess menstrual cycle and determine whether symptoms are related to perimenopause or another condition. Dr Abha says investigations may also help identify other possible explanations, including vitamin deficiencies or thyroid problems.

“So, they can be sorted out. So don't avoid going to a doctor if you feel something is changing in your body. And what you were coping with earlier, you're not being able to cope with that.”

Breast cancer is generally considered to be a problem of old age. In India, however, breast cancer is usually diagnosed in women who are in their 40s and 50s, a decade before the average age group in several other parts of the world. While this difference has clinical significance, the reasons behind it are varied and cannot be pinned down to any one biological or genetic cause.

Reproductive and lifestyle differences

Age, hormones, heredity, reproductive history and environment play roles in determining the risk of breast cancer. Historically, differences in age at first birth, number of pregnancies and breastfeeding period could have been responsible for the variance seen in risk levels across populations. Presently, the changing pattern of reproduction, late age of first pregnancy, lower number of births and less breastfeeding among certain groups of Indians could affect the risk of breast cancer.

Other changes include dietary, physical activity and body weight trends due to urbanization. Being overweight, especially postmenopausal, and excessive alcohol intake are known risk factors for breast cancer. But this alone does not account for the difference in age profile of breast cancer in India.

Genetic susceptibility is another factor which needs to be taken into account. Mutations in the inherited genes, including BRCA1 and BRCA2, may lead to the increased risk of development of breast cancer in young women. Nonetheless, there is no sufficient information to suggest that a particular genetic background specific for the Indian population contributes to this difference. More research in the field of genomics is needed.

Another thing to take into account is that the young age of the patients does not mean that the breast cancer occurs more frequently in India compared to other countries. Higher age-standardized incidence rates have been observed in Western countries due to reproductive behaviors, lifestyles, and screenings. Younger age of Indian patients may also be explained by demographic factors, as well as the difference in screenings and diagnoses.

Also read: Breast Cancer: Know the Risks, Recognise the Signs & Get Checked

Do young Indian women tend to develop aggressive cancers?

Indian cancer centers report significant shares of hormone receptor-negative, HER2-positive, and triple-negative breast cancers, as well as a more advanced stage of the disease at the time of diagnosis. Aggressive biological types among these subgroups might require aggressive therapy.

Nonetheless, it is critical not to generalize this information and apply it to all Indian women and breast cancers developed at a younger age. It may be questioned whether hospital-based studies reflect the whole population, as there is variation in tumour subtypes within the population.

Late diagnosis is one of the main problems. Poor awareness, fear and stigma, family obligations, financial constraints and delayed health-care visitation result in growth and spread of tumours before starting treatment. Young women may ignore a breast lump because they think that being young prevents them from developing breast cancer. It may be dangerous.

Should breast cancer screening start early in India?

The issue requires clarification between awareness, diagnosis and screening.

Breast awareness should start in early adulthood. Women should be aware of their normal breast condition and have an immediate medical check up if they find any changes such as a breast lump, nipple retraction, bleeding nipple discharge, skin dimpling and others, regardless of age. Suspicious change requires diagnosis rather than waiting until next screening examination.

In asymptomatic women, it is necessary to determine the ideal age and screening method according to Indian conditions. Mammography is well-known screening tool, ultrasound could assist in evaluating dense breast tissue in younger women. Both should not be over-used without proper medical evaluation. Women who have a robust family history or those carrying high-risk genes should have an earlier and more rigorous surveillance program.

What India requires is a systematic and risk-appropriate early detection program that includes public awareness, medical evaluation, screening, and treatment.

The bottom line is that breast cancer does not occur only among older patients. Early detection of symptoms and changes can make a difference in saving lives.

By Dr Sewanti Limaye, Director of Medical & Precision Oncology, Sir H. N. Reliance Foundation Hospital, Mumbai