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Redefining obesity could increase numbers by 50%

Monday, March 17, 2003

By Michael Woods, Post-Gazette National Bureau

WASHINGTON -- The number of people worldwide who are officially regarded as overweight or obese may increase by 600 million -- almost 50 per cent -- as scientists move to adopt a new definition of abnormal body weight.

Dr. Philip James, chairman of the London-based International Obesity Task Force, will describe the revision in a lecture being delivered today at a medical seminar.

The task force is part of the International Association for the Study of Obesity, which includes 10,000 scientists, physicians, and other and health professionals in 44 countries. It is doing research on obesity's role in disease for the World Health Organization (WHO), a United Nations agency headquartered in Geneva.

James said the revised figure now being considered for adoption is based on recommendations from a WHO expert panel.

If adopted by WHO, the recommendations would place enormous new demands on health care systems to provide effective weight-control treatment, he indicated.

Members of the WHO panel, which included James, found that people of Asian heritage are unusually sensitive to weight-related health problems, such as Type 2 diabetes and heart disease.

Their risks begin at a lower body-mass index (BMI) than previously believed. BMI is the medical measure of obesity. It is a mathematical formula that expresses the relationship, or ratio, of a person's weight to his height.

WHO's traditional definition put the threshold for overweight at a BMI of 25 and obesity at a BMI of 30. Under that definition, 1.1 billion people now are considered overweight or obese. The new threshold for Asians would be a BMI of 23.3.

Adoption of the new BMI would put the global overweight/obese population at 1.7 billion, James said, explaining that huge numbers of people in Asia already have a BMI of 23.4 and above.

James, who chaired the U.N. Commission on the Nutrition Challenges of the 21st Century, described obesity as a fast-spreading global epidemic. The proportion of obese people in the United States, for instance, doubled from 14 per cent in 1978 to almost 32 per cent today.

Hidden in those figures, however, is a dramatic rise in "super-obesity," he said. Medically known as "morbid obesity," the condition involves a BMI of 40 or more. Those enormous weight gains interfere with walking, breathing, and other activities and may pose an immediate health threat.

James said that morbid obesity is doubling every decade. One in every 16 American women now is super obese, he said.

Michael Woods can be reached at mwoods@nationalpress.com or 1-202-662-7072.

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