BMI alone misses many cases of obesity, expert says

The body mass index (BMI) is no longer sufficient on its own to identify obesity, an expert told ORF Steiermark, calling for a broader medical definition.

About half of people aged 15 and over in Styria are overweight, the report said, and the number may be higher than recorded. BMI categories range from normal weight to grade III obesity, but they do not capture everyone with excess body fat, said Hermann Toplak, a Styria-based specialist in internal medicine and an obesity expert.

Toplak said some people classified as normal weight or overweight can still have too much body fat. Among people of normal weight, only about one third have a normal body-fat level, he said. Toplak founded the Austrian Obesity Society in 1997.

He also said weight gain can result from medication, including drugs prescribed by psychiatrists and gynaecologists. Hormone injections can lead to weight gains of up to 40 kilograms, he said, adding that patients are not always weighed or the weight gain noticed.

Toplak said hospital discharge letters often omit obesity diagnoses and instead record diabetes, which he said brings revenue to hospitals. Experts also criticised the lack of coverage for lifestyle counselling and obesity medication. Medication costs are reimbursed when needed for people with diabetes, the report said.