Beyond BMI - Phenotyping the Obesities - European Association for the Study of Obesity (EASO)
For more than a decade, researchers in the field of obesity have debated the value of the BMI as the most common and convenient index for classifying the obese condition. The implications of using BMI are profound. The cut-off points of BMI of <18.5 kg/m2 , 18.5–24.9 kg/m2 , 25.0–29.9 kg/m2, 30.0–34.9 kg/m2, 35.0–39.9 kg/m2 and 40.0+ kg/m2 define categories usually referred to as underweight, normal weight, overweight (pre-obese) and obese (grades I, II and III). These cut-off points therefore define the number of individuals falling into each category which, in turn, tells us the prevalence of obesity on the planet. However, the essence of obesity is adipose tissue in the body (not a relationship of height and weight), so the BMI can only serve as an indirect estimate of obesity. Obesity is defined as an excess accumulation of body fat, and this excess fat is normally conceived as an indicator of poor health and, in turn, constitutes a risk factor for a range of diseases including diabetes, ischaemic heart disease, hyperlipidaemia, sleep apnoea, arthritis and others. This Guideline aims to highlight the implications of using BMI as a measurement for obesity.