More Americans Could Be Classified as Obese Under New Definition, Study Suggests
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New criteria for obesity are putting more Americans in that category.
Researchers at Mass General Brigham have proposed a major update to how obesity is defined, which would classify nearly 70% of American adults as obese, according to a new study published in JAMA Network Open.
The new benchmark adds waist and body fat measurements to BMI, revealing the locations of body fat rather than just overall body weight.
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With these new criteria, the estimated obesity rate in the US increases from 42.9% to almost 70%, after examining 300,000 people.
This captures a range of people who might previously have been considered healthy, but who actually face a higher risk of diseases such as heart disease and diabetes.
A new definition of obesity considers that almost 70% of American adults are obese. (iStock)
The increase was greatest among older adults, with nearly 80 percent of participants over age 70 reaching the obesity mark, the researchers noted.
The study highlights the limitations of a BMI-based approach, which does not consider how fat stored throughout the body can predict overall health.
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Co-first author Lindsay Fourman, MD, an endocrinologist in the division of endocrinology at Mass General Brigham’s Department of Medicine, reacted to these findings in a statement.
“We already thought we had an obesity epidemic, but this is surprising,” he said. “Now that potentially 70% of the adult population is considered to have excess fat, we need to better understand which treatment approaches to prioritize.”
A BMI-based approach may miss those at risk for underlying diseases, the study suggests. (iStock)
The accumulation of abdominal fat, known as visceral fat, “has long been recognized as metabolically harmful,” according to Philip Rabito, MD, an endocrinology, weight loss and wellness specialist in New York City.
It is also linked to an increased risk of diseases such as diabetes, dyslipidemia, hypertension and cardiovascular disease, he told News Digital.
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Redefining obesity to include patients with a high-risk fat distribution could help “direct greater clinical attention and resources” to this “vulnerable” group, Rabito suggested.
“In addition, a greater number of these patients could become eligible for GLP-1-based therapies than under previous definitions, with the potential to significantly reduce their future cardiovascular risk,” he added.
The new definition of obesity may help “direct greater clinical attention and resources,” one doctor noted. (iStock)
Dr. Mary Claire Haver, a board-certified OB-GYN and founder of The ‘Pause Life, also said she wasn’t surprised by the study’s findings.
“I’ve been watching this trend develop in my clinic for years,” the Texas doctor told News Digital. “What concerns me most is that headlines like this often rely almost exclusively on weight-based measures like BMI, which are blunt tools and overlook what actually creates long-term health risks.”
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He added: “From a physiological and metabolic point of view, fat distribution matters much more than body weight alone.”
Haver reiterated that visceral fat, stored deep in the abdominal organs, is the “main driver” of insulin resistance, cardiovascular disease, fatty liver disease and inflammatory risk. Visible fat on the surface, called subcutaneous fat, does not carry the same metabolic risk when combined with “adequate muscle mass.”
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“In my patient population, I routinely see people who technically meet BMI-based obesity criteria, but who have high lean muscle mass, relatively low visceral fat, and excellent metabolic health,” he said.
“This group represents approximately 20% of the patients labeled as obese in my practice, and they require very different nutritional counseling and recommendations than patients with significant visceral adiposity.”
Focusing solely on weight can obscure who is “really at risk,” Haver warned, and contributes to stigma while distracting from the “real problem” of metabolic health.
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“Tools that assess body composition, waist circumference and markers of insulin resistance give us a much more accurate picture than the scale could ever give us,” he said.
The doctor projected that obese population numbers will likely improve with the expansion of GLP-1 drugs.
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“But if we don’t shift the conversation away from weight solely toward body composition and fat distribution, we will continue to misclassify risk and miss opportunities for more personalized and effective care,” he added.
Angelica Stabile is a lifestyle reporter for News Digital.