A new medical framework for defining obesity could dramatically reshape how doctors diagnose and treat one of America’s most widespread health issues. According to Study Finds, the updated criteria — which add waist measurements to traditional body mass index (BMI) — would raise the national obesity rate from 42.9% to 68.6%.
A Broader Picture of Health
The findings, published in JAMA Network Open, come from an analysis of health data from more than 300,000 Americans in the All of Us research program. The study is the first large-scale look at how new obesity guidelines, endorsed by 76 professional medical organizations, could change clinical care across the country.
Researchers explained that the traditional BMI scale often misses people with unhealthy fat distribution. The new method combines waist circumference, waist-to-hip ratio, and waist-to-height ratio to capture a more complete picture. “Belly fat, regardless of overall weight, serves as a key predictor of metabolic disease,” said lead author Dr. Lindsay Fourman of Massachusetts General Hospital, as reported by Study Finds.
Scientists identified a group they call “anthropometric-only obesity” — people whose BMI appears normal but who carry excess fat around their midsection. This “hidden” belly-fat obesity affected more than 78,000 participants, many of whom would not have been flagged under previous definitions.
Hidden Health Risks
Tracking participants over four years, the study found that those with waist-centered obesity faced significantly greater health risks. Compared to people without obesity, they were 76% more likely to have organ problems, more than twice as likely to develop diabetes, and had a 55% higher risk of heart disease, according to Study Finds.
The conditions most commonly associated with this form of obesity included high blood pressure, sleep apnea, and reduced physical mobility — ailments that often develop gradually and go unnoticed until they become serious.
Who Is Most Affected?
Age and demographics played a major role in the findings. Among younger adults aged 18 to 29, 43.9% met the new obesity criteria. Among seniors, that number jumped to 78.3%, reflecting how fat distribution changes over time.
Asian participants experienced the largest relative increase, with obesity prevalence rising 90.3%, from 27.0% to 51.4%, under the new definition. Men were also more likely to have this hidden obesity than women — 32.5% compared to 21.7%, Study Finds reported.
Implications for Treatment and Policy
The research suggests that new definitions could upend how healthcare systems, insurance programs, and physicians approach obesity treatment. Currently, less than half of adults meet BMI-based qualifications for anti-obesity medications. Under the new framework, about half of those currently eligible could be reclassified as “preclinical” or not obese, while another group previously overlooked might newly qualify for treatment.
The new model distinguishes between “clinical obesity,” when weight is already causing health problems, and “preclinical obesity,” when early signs of risk are present but major symptoms haven’t appeared. Even those in the preclinical stage faced “more than three times the risk of developing diabetes and 40% higher risk of heart problems” than people without obesity, according to Study Finds.
Dr. Fourman called the results “astounding,” noting that “with potentially 70 percent of the adult population now considered to have excess fat, we need to better understand what treatment approaches to prioritize.”
A Shift in Public Health Priorities
Implementing the expanded definition would require more screening, training, and data integration, but researchers argue that the effort could save lives by identifying at-risk individuals earlier. The study’s traditional BMI-based rate of 42.9% closely matches CDC estimates for the current U.S. population, suggesting that these new findings could reflect nationwide trends.
If adopted, the new approach could redefine the national conversation about obesity — not just as a number on a scale, but as a more nuanced measure of body composition, risk, and long-term health.
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