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This study of 13,160 Mexican adults found that using BMI alone to define obesity misses important cases of clinically relevant obesity characterized by excess central fat. While 34.5% of adults had obesity by BMI criteria, 30.9% met clinical obesity definitions that include waist measurements, with one quarter of those with clinical obesity having a BMI below 30 kg/m2. Half of adults with normal or overweight BMI showed elevated central adiposity, indicating metabolic risk not captured by BMI alone.
Why it matters
The findings suggest that relying solely on BMI in clinical practice and public health surveillance may fail to identify many individuals at risk for obesity-related metabolic complications. Incorporating waist-based measurements alongside BMI could improve early detection and intervention for cardiometabolic disease, particularly in populations where central adiposity is common despite lower BMI values.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Body mass index (BMI) alone may underestimate clinically relevant obesity because it does not capture central fat distribution. We compared obesity prevalence in Mexico using BMI-only criteria, adiposity-confirmed criteria, and the clinical obesity definition proposed by the Lancet Diabetes and Endocrinology Commission. We conducted a population-based, cross-sectional study of 13,160 adults aged 18 years or older who participated in the 2018-2019 Mexican National Health and Nutrition Survey (ENSANUT). Obesity prevalence was estimated through survey-weighted analyses that accounted for the complex sampling design. The weighted prevalence of obesity based on BMI was 34.5% (95% CI, 33.1-35.9), while 30.9% (95% CI, 29.6-32.2) met criteria for clinical obesity. One quarter of individuals with clinical obesity had a BMI under 30 kg/m2, a phenotype more common among older adults. Half of adults with a BMI under 30 kg/m2 showed elevated central adiposity. BMI alone underestimates clinically relevant obesity in Mexican adults. Adding waist-based measurements could improve the identification of individuals with excess fat and metabolic risk, both in clinical settings and population monitoring.
Source: Prevalence of excess adiposity and clinical obesity in a Mexican nationally representative survey