Over 26% of U.S. adults with a normal BMI met new criteria for clinical obesity proposed by the Lancet commission.About 78% of adults had excess adiposity if defined by using two or three abnormal body measurements.Researchers called for studies to determine whether screening with the new obesity framework actually improves downstream health outcomes.
Over a quarter of U.S. adults with a normal body mass index (BMI) met recently proposed criteria for clinical obesity, a national cross-sectional study found.
Among adults with a BMI in the normal range of 18.5-24.9, an adjusted 26.1% had clinical obesity by the Lancet Diabetes & Endocrinology commission criteria, defined by abnormal anthropometric measurements with organ or physical dysfunction, researchers led by Brian Lee, MD, of the University of Southern California in Los Angeles, reported in the Annals of Internal Medicine.
Clinical obesity prevalence jumped to 50.3% for those in the overweight BMI category (25-29.9), 65.6% for those with class I obesity (BMI 30 to <35), 77.8% for class II obesity (BMI 35 to <40), and 85.3% for class III obesity (BMI ≥40).
The Lancet commission pitched the new diagnostic framework in January 2025, advocating for a more nuanced approach than provided by the ratio of height to weight that defines BMI. The commission proposed that clinicians verify obesity status using at least one additional anthropometric measure -- such as waist circumference, waist-to-hip ratio, or waist-to-height ratio -- or direct fat mass measurements via dual-energy x-ray absorptiometry (DEXA) scans or bioimpedance.
