A group of scientists is proposing a new way to determine excess body fat. What is the science behind the idea, and how does it differ from the standard techniques used in the past?

International Panel of Scientists Recommends New Way to Calculate Excess Body Fat

For decades, the body mass index (BMI) has been the gold standard in determining if an individual is at a healthy weight. However, an international committee of scientists is pushing for the adoption of a new technique to assess overall health as it is connected to body weight.

Over 50 experts from various health-related fields, including public health, nutrition, and endocrinology, published their recommendations in the widely respected The Lancet Diabetes & Endocrinology journal. The recommendation details that BMI does not dig deep enough into the weeds when determining how weight relates to a person's health profile.

Instead, the group said that the amount of belly fat is a better indicator of a person's health. According to the scientists, the traditional BMI is not nuanced enough to offer a clear picture.

The authors recommend that belly fat can be measured in a variety of different ways in an effort to provide a more accurate representation of how a person's size might be impacting their health. Belly fat can be calculated by measuring a person's waist directly, the waist-to-hip ratio, or the waist-to-height ratio. Doctors can also employ the use of technical scans for a more precise measurement of excess belly fat.

Conversely, BMI is calculated using only two data points. These data points are a person's height and their weight.

How BMI Measurements Can Be Inaccurate

The researchers who recommend leaning on excess body fat measurements claim that the sole use of BMI can result in both over- and underreporting of obesity. For instance, an individual with a BMI designation of "healthy" may actually be packing dangerous excess fat around vital organs. Likewise, an athlete in prime shape may have a BMI designation of "obese" because muscle mass naturally weighs more than fat.

Dr. Robert Kushner, an endocrinologist at Northwestern University and member of the report's commission, said that too much belly fat raises the risk of several health concerns.  "Fat in the belly causes systemic inflammation, which then goes on and causes other metabolic problems like elevated blood sugar, elevated blood pressure, and increased fats in the blood," he said. Kushner went on to detail that “This can set the stage for metabolic diseases including diabetes as well as heart disease.”

Although Kushner said that the commission does not advocate for the complete abolishment of BMI as a tool, he believes that it is important to also use the measurement of excess body fat when determining a patient's overall health outlook.

Dr. David Cummings, an obesity expert at the University of Washington and a doctor on the commission, noted that the goal of the report is to “get a more precise definition [of obesity] so that we are targeting the people who actually need the help most.”

In addition to recommending that healthcare professionals look at excess body fat, the report's authors also advised using two different diagnostic categories to define obesity. By looking at both clinical obesity and pre-clinical obesity, doctors will get a clearer view of what steps should be taken next.

For example, patients who exhibit excess body fat while also demonstrating signs of high blood pressure, heart disease, or chronic joint pain related to weight would fall under the designation of clinically obese. However, people who carry excess weight but do not display any of the chronic health issues typically related to excess weight would be diagnosed with pre-clinical obesity.

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