Modern Australian
Men's Weekly

.

BMI shouldn’t be the only way to assess who can access weight-loss drugs

  • Written by Liz Sturgiss, Professor of Community Medicine and Clinical Education, Bond University
BMI shouldn’t be the only way to assess who can access weight-loss drugs

Around one in three Australian adults (32%) has a body-mass index (BMI) of 30 or above. A further 34% has a BMI of 25 or above.

Australia’s regulator has approved Wegovy, the weight-loss version of Ozempic (semaglutide) and Mounjaro (tirzepatide) for weight management, alongside a reduced-calorie diet and exercise.

To access these medications, adults must have a BMI of 30 or above or a BMI of 27 and a weight-related condition such as high blood pressure or sleep apnoea. The drugs aren’t subsidised on the Pharmaceutical Benefits Scheme (PBS) for weight loss, so users face still high out-of-pocket costs.

These drugs work by activating the GLP-1 receptor, which increases insulin secretion and improves the liver’s use of glucose. This decreases the user’s appetite, leaving them feeling fuller after eating less. In trials, these medications reduced participants’ body weight by up to 20% and improved their health outcomes and quality of life.

But while doctors and allied health providers are reducing their reliance on BMI to guide treatment decisions, eligibility for Wegovy and Mounjaro rely on it. This needs to change.

Your BMI alone doesn’t reflect your health status

A Belgian mathematician first invented BMI in the 1830s to try and quantify the “average man”.

An American physiologist and dietitian then adopted BMI in the 1970s to screen for obesity. It has since been used a tool to screen large populations for obesity.

BMI was never meant as the sole measure for a person’s health. When we use BMI with an individual patient, it can often overestimate the risk of their weight on their health. People have a lot of muscle mass, for example, may have a high BMI but low health risks.

BMI can also underestimate a peron’s weight-related health impacts, such as the risks for elderly people with low muscle mass.

Weight doesn’t tell us the whole story about a person’s risk for poor health. But because it’s easy to see a person’s physical shape, it’s often incorrectly used as a marker of healthiness.

It’s possible to improve your health by eating a more nutritious diet and getting more active, even if your weight doesn’t change.

For people who don’t move much during the day, increasing physical activity can boost your heart, lung and mental health.

The definition of obesity might also change

Obesity is most commonly diagnosed when a peson’s BMI is 30 or above.

But earlier this year, an international committee recommended changing how obesity is diagnosed. In its view, a person with a high amount of body fat that is having an impact on their health should be diagnosed as having obesity. So should those with a BMI over 40.

However, according to its recommendations, to diagnose obesity at lower BMIs, a health practitioner should assess the person’s waist circumference or directly measure their body fat, through a special set of scales that directly measures percentage body fat.

These measurements would be assessed according to different cut-offs for obesity based on age, gender and ethnicity.

On top of these body measurements, it also proposes a new diagnosis of “clinical obesity”. This would be given when there is evidence of organ dysfunction or obesity impacting every day function. This way of diagnosing obesity looks at overall health, and not just BMI.

The committee recommended weight-loss treatments, including medications, should be individualised and evidence-based.

What other indicators could clinicians use?

Obesity is complex, with each person experiencing it differently. So rather than basing weight-loss medication eligibility on BMI, clinicians should be able to consider the potential benefits (and risks) for an individual.

The Edmonton Obesity Staging System is a good example of a measure that uses BMI plus any other health conditions the person has, how the person moves and functions day to day, and psychological symptoms such as depression or low mood.

A higher stage is associated with poorer health outcomes, such as having organ damage, being unable to work, or having major depression. A moderate stage might include having high blood pressure, having some limitations on your daily activity and subsequent impacts on quality of life. This staging could help determine who would get the most benefit from weight-loss medicines.

A more comprehensive assessment of health using the Edmonton Obesity Staging System could help patients and their doctors have an informed discussion about the benefits and drawbacks of weight-management medications. For example, the medications could be targeted to people with higher stages rather than just relying on BMI.

This could mean people with lower BMIs, but more health conditions or difficulty with physical function, could decide to use medications, as they would be more likely to have health benefits.

Don’t overlook nutrition and exercise

While medications can help many users improve their health, they won’t be suitable or work for everyone. And not everyone will sustain the same level of weight loss, especially if they’re not supported with dietary changes and exercise.

Research trials of these medications have included the best nutrition, physical activity and psychological support for patients undergoing treatment. Weight-loss drugs should always be used in conjunction with these other supports to get the best health outcomes.

Whether you use weight-loss drugs or not, if you have weight-related health issues, you’re more likely to improve your physical function, your other health conditions and quality of life if you have support from a team of health professionals. This might include a dietitian, exercise physiologist, psychologist and care from a trusted GP.

Authors: Liz Sturgiss, Professor of Community Medicine and Clinical Education, Bond University

Read more https://theconversation.com/bmi-shouldnt-be-the-only-way-to-assess-who-can-access-weight-loss-drugs-263634

5 Signs Your Pool Filter Needs Professional Cleaning

Is your pool water looking cloudy, your pump working overtime, or the jets losing pressure?  These are common warning signs that your pool filter mi...

Social Media: Is It Increasing Rates of Anxiety and Depression?

In today’s connected world, social media has become an integral part of daily life. Platforms like Instagram, TikTok, and Facebook offer opportuni...

Preventive Maintenance Tips for Hydraulic Equipment

Hydraulic equipment plays a crucial role in industries ranging from construction and mining to agriculture and manufacturing. Whether it’s powerin...

Choosing the Right LiDAR System for Your Project

When planning a project that relies on accurate spatial data, selecting the right LiDAR system is one of the most critical decisions you’ll make. ...

The History of Craft Beer: From Monasteries to Modern Breweries

Craft beer has a rich and fascinating history that stretches back centuries. What we enjoy today in trendy taprooms and bustling breweries is the re...

How Natural Pearls Shaped Trade Routes and Global Economies

Throughout history, natural pearls—those rare, untamed treasures formed by nature itself—have exerted a powerful influence on trade networks, po...

How To Choose The Right Insulation For Your Space

Selecting the appropriate insulation for your home or building is a critical decision that affects comfort, energy efficiency, and present and future ...

7 Best Things to Do in Beaufort, Victoria

Beaufort is a charming small town in Victoria’s Goldfields, full of history, natural beauty, and warm, welcoming locals. Whether you’re passing th...

What to Expect During Divorce Mediation & Settlement

Divorce can be a difficult and emotionally draining process, but mediation and settlement often provide a constructive path forward. Instead of goin...

Navigating Disability Services in Perth: Your Questions Answered

Understanding the landscape of disability support can feel overwhelming, especially when you're just starting out. If you’re looking for support a...

How Veneers and Dental Implants Work Together for Full Smile Restoration

Modern dentistry has strong instruments that can produce life-changing outcomes when it comes to repairing a smile that has been impacted by tooth los...

Gen Z’s Are Going off Grid – But Is It Sustainable?

Australia’s cost of living crisis is causing Gen Z to get creative with frugal living options. Earlier this year, young couple Koby and Amelie wan...

The Risks of DIY Air Conditioning Installation and How to Avoid Them

Air conditioning is essential in Australia, especially during the scorching summer months, when homes and workplaces can become unbearable without rel...

How to Find Reliable Air Conditioning Services Near You in Brisbane Northside

Introduction In Brisbane’s hot and humid climate, air conditioning has become more of a necessity than a luxury. Whether it's keeping your home coo...

Enhance Outdoor Living with Lifestyle Awnings

Creating the perfect balance between indoor comfort and outdoor living is something many homeowners aspire to achieve. In recent years, Lifestyle Aw...

Why Buckets with Lids Are Essential for Safe Storage & Transportation

The right bucket can streamline transport and make handling easier day to day. With options suited to food, chemicals and construction materials, th...

Comfort and Style with Ceiling Fans Perth

While air conditioning is common, it is not always the most cost-effective or sustainable solution, particularly during long hot summers. For homeow...

How Professional Air Conditioning Services Improve Comfort and Efficiency

Air conditioning has become a fundamental part of homes and businesses, providing relief from sweltering summers and keeping interiors warm in winte...