Give SLIM people Ozempic! Experts propose overhaul of BMI guidelines that could reclassify millions of Brits who are a healthy weight as 'obese'
Carrying round a small beer belly or 'muffin-top' but reassured by your not-obese body-mass-index (BMI) result? You may still need obesity drugs like Ozempic, experts have suggested.
Obesity experts are calling for an overhaul of the BMI system, claiming too many 'skinny fat' people, those with high levels of excess blubber around their stomachs, are not getting obesity treatments they could benefit from.
This fat, technically called abdominal fat, wraps around the vital organs and is considered more dangerous than subcutaneous fat which sits just beneath the skin.
High levels of abdominal fat has been linked to a higher risk of heart disease, diabetes, stroke, certain cancers and dementia.
But despite its risks people can have high levels of abdominal fat and be nowhere near the BMI of 30 threshold the NHS uses to determine if people are obese.
Obesity experts are calling for an overhaul of the BMI system, claiming too many 'skinny fat' people, those with high levels of excess blubber around their stomachs, are not getting obesity treatments they could benefit from
If adopted the recommendation could see people with a BMI of over 25 recommended to take obesity drugs like semaglutide, sold under the brands Wegovy and Ozempic, which are currently restricted to people with a BMI of around 30 in the UK
Experts say this means so-called 'skinny fat' people aren't getting treatments that could help improve their health, such as new generation obesity busting drugs like the injections Ozempic and Wegovy.
A coalition of experts from the European Association for the Study of Obesity (EASO) have now called for the system we use to give people obesity drugs, having a BMI of 30 plus, to be overhauled.
They said that people with a BMI of over 25 and a waist-to-height ratio (WHtR) of above 0.5 as well as the presence of a weight-related health complication, like high blood pressure or diabetes should also be considered for obesity medications.
Abdominal fat is most accurately measured with a high-tech scan, like an MRI, but these are expensive, and in limited supply, so experts typically use WHtR which is your waist measurement divided by your height.
A result of 0.5 or higher is a general indication that abdominal fat levels are too high.
Writing in the journal Nature Communications the EASO experts said there was currently an overreliance on BMI as a diagnostic criteria for obesity interventions that needed to change.
'The basis for this change is the recognition that BMI alone is insufficient as a diagnostic criterion, and that body fat distribution has a substantial effect on health,' they wrote.
'More specifically, the accumulation of abdominal fat is associated with an increased risk of developing cardiometabolic complications and is a stronger determinant of disease development than BMI, even in individuals with a BMI level below the standard cut-off values for obesity diagnosis (BMI of 30).'
They added how pharma companies may want to use their new BMI over 25 diagnostic threshold for new clinical trials of obesity interventions.
The 29 EASO experts who penned the recommendation included specialists in endocrinology, nutrition, internal medicine, bariatric surgery, primary care, as well as one patient advocate.
In total, 79 per cent of the experts consulted agreed that obesity medications should be considered in patients with a BMI of over 25, a WHtR of 0.5 or more, and the presence of 'medical, functional or psychological impairments or complications'.
Under the BMI system, a score of 18.5 to 25 is healthy. A score of 25 to 29 counts as overweight, and 30-plus means a person is obese, the stage at which chances of illness rocket
More than 42million adults in the UK will be overweight or obese by 2040, according to projections by Cancer Research UK
The NHS is one of those health authorities that use a BMI of 30 or above as a criteria to access some obesity medications.
For example, to access semaglutide, the active ingredient in both Ozempic and Wegovy, patients must have a BMI of at least 30, or 27.5 if they belong to certain ethic groups, to be eligible for the medication on the NHS.
Similarly high BMI restrictions apply to other obesity medications on the NHS.
This isn't the first time experts have called for BMI to be overhauled.
BMI was devised by a Belgian mathematician in the 1830s, and doctors have relied on it as measure of obesity for almost two centuries.
It is backed by the World Health Organization and used by doctors around the world to determine if a person is at risk of a host of diseases from diabetes, heart attacks and strokes due to excess fat.
But one major flaw is that it is incapable of differentiating between fat distribution and muscle mass.
This means a fit rugby player and couch potato of the exact same height and weight share the same scores — even if the former has a ripped physique and the other carries a spare tyre.
NHS data shows only 26 per cent of adults have a BMI of 30-plus.
But the average BMI of all adults over 40 in the UK varies between 27.7 and 27.6, suggesting the majority would be declared obese, and at risk, under the proposed overhaul.
