Obesity: A Complex Health Challenge Redefined

Obesity Declared a Disease - BMI Isn't Everything About Health

In the United Arab Emirates, health experts are increasingly asserting that obesity qualifies as a standalone disease. The traditional Body Mass Index (BMI) is no longer considered a sufficient diagnostic tool—experts instead recommend using alternative metrics such as waist circumference, waist-to-hip ratio, or bone density assessments.

The latest professional approach distinguishes between two categories: clinical obesity and preclinical obesity. This classification aids in diagnostic accuracy and the development of personalized treatment plans.

What Do Clinical and Preclinical Obesity Mean?

Clinical obesity is a condition that clearly affects the body's functioning, including the appearance of symptoms like heart disease, breathlessness, type 2 diabetes, or joint pain. These symptoms indicate that excess weight is not only an aesthetic or static problem but actually damages the body.

Conversely, preclinical obesity is a state where body weight exceeds the ideal value, but internal organs are still functioning properly. These individuals are at increased risk but do not yet require active medical intervention. The goal of this category is to provide a warning and opportunity for prevention—such as by adopting a healthier lifestyle, engaging in regular physical activity, or consulting a nutritionist.

Why Isn't BMI Enough?

The Body Mass Index has long been one of the most commonly used methods for determining obesity levels. However, it has faced growing criticism because:

- It doesn’t account for the distribution of fat on the body,

- It doesn’t differentiate between muscle and fat mass,

- It ignores bone density and body type differences.

As a result, doctors recommend assessing the waist-to-hip ratio, which more accurately shows where fat is stored in the body. Abdominal (visceral) excess fat, for example, poses a greater risk for cardiovascular diseases, diabetes, and other metabolic problems—even if the BMI is within a normal range.

Additionally, bone density measurement can also be important for those who might be diagnosed with obesity based on body weight, yet, in fact, have more muscle mass or specific bone characteristics. This test uses low-dose X-rays to determine the balance between fat and muscle tissue.

The Benefits of Early Detection

The new classification helps avoid overdiagnosis and unnecessary medical interventions. Those who fall into the preclinical obesity category require regular monitoring but do not necessarily need medication or surgical treatment.

This approach reduces stigmatization and provides an opportunity for prevention. If the problem is recognized in time, lifestyle changes can prevent the development of a more severe clinical condition.

The Stigmatization of Obesity: A Social Issue

People living with obesity often face humiliation, ridicule, or social exclusion. This issue doesn’t just affect adults but appears in childhood as well—at home, in schools, or workplaces. This type of stigmatization can lead to serious long-term psychological consequences, such as reduced self-esteem, depression, social isolation, and even the development of addictions.

Experts emphasize that obesity cannot be judged based solely on appearance. A person’s health needs to be assessed in a much more complex way, and care should be taken about how we talk about others.

Summary

UAE health experts advocate a new approach to obesity: they recognize it as an illness but also highlight the need for a differentiated approach. BMI alone is no longer suitable for diagnosis and instead calls for complex, multidimensional assessments.

(Source: Based on articles by obesity experts.)