Study Confirms BMI Alone Can Miss Important Health Risks Associated with Obesity

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CU Anschutz physician among international researchers validating a new approach to diagnosing obesity that better identifies health risks and mortality AURORA, Colo., Nov. 11,…

CU Anschutz physician among international researchers validating a new approach to diagnosing obesity that better identifies health risks and mortality

AURORA, Colo., Nov. 11, 2026 /PRNewswire/ -- A new approach to diagnosing obesity provides a more accurate picture of who faces serious health risks, and who may benefit from treatment, than body mass index (BMI) alone, according to an international study published in Nature.

The research, led by King's College London and involving 844,108 adults from China, Spain, the United Kingdom and the United States, validates a new diagnostic framework that distinguishes between clinical obesity, in which excess body fat impairs organ function or daily activities, and preclinical obesity, in which excess body fat poses health risks but organ function remains intact.

Robert H. Eckel, MD, of the Division of Endocrinology, Metabolism, Diabetes and Cardiology at the University of Colorado Anschutz, was one of two U.S.-based researchers involved in the international study.

The findings highlight limitations of relying on BMI alone to diagnose obesity. By incorporating additional measurements, including waist circumference and waist-to-height ratio, researchers found that BMI alone both overestimated and underestimated obesity across all four study populations. The combined approach identified obesity in an additional 3.3% to 7.4% of participants, depending on the population.

Importantly, the researchers found that the new classification better distinguished differences in health outcomes. Over 10 years, clinical obesity was associated with a substantially higher risk of death, while preclinical obesity carried only a modest increase in risk. Between 77% and 91% of people classified as having preclinical obesity did not progress to clinical obesity over a decade.

"These findings reinforce that obesity is not a one-size-fits-all diagnosis," said Eckel. "BMI can be a useful starting point, but it doesn't tell us enough about whether body…

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