How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations.

TLDR

Metabolic risks are greater in Asians than Caucasians at a given BMI, and BMI cut‑offs for overweight and obesity should be lower for Asians, yet percent body fat and metabolic responses vary among Asian ethnic groups, so multiple action points (BMI 23, 25, 27.5, 30, 32.5, 35, 37.5) have been advocated for managing obesity in Asians. The study proposes evidence‑based ethnicity‑specific action points for public awareness, screening, and treatment of obesity in Asians. These action points are derived by evaluating sensitivity, specificity, and positive/negative predictive values for cardiovascular disease and metabolic syndromes.

Abstract

Metabolic risks are greater in Asians than Caucasians at a given body mass index (BMI). It is generally accepted that the BMI cut-off points for defining overweight and obesity should be lower for Asians. However, the percent body fat at a given BMI and metabolic responses to fatness vary among the different ethnic groups in Asia. Therefore, roughly even-spaced multiple action points (i.e., BMIs of 23, 25, 27.5, 30, 32.5, 35 and 37.5) have been advocated for managing obesity in Asians. We propose here evidence-based ethnicity-specific action points for public awareness, screening, and treatment that take into consideration sensitivity, specificity, and positive/negative predictive values for cardiovascular disease and/or metabolic syndromes, which are the most preva-lent adverse consequences of obesity.