Experts in India are urging the recognition of abdominal obesity as a new vital sign in Asian Indians to better assess metabolic health risks. An editorial by Amerta Ghosh and Anoop Misra emphasizes the need to measure waist circumference in all patients. This shift addresses the limitations of BMI as a measure of obesity.
The progressive rise in obesity and abdominal obesity in India signals a major metabolic crisis, fueling the increasing prevalence of type 2 diabetes, cardiovascular disease, metabolic dysfunction-associated steatotic liver disease (MASLD), and related cardiometabolic disorders. Asian Indians often develop abdominal obesity even with relatively normal BMI, a trait linked to greater insulin resistance, ectopic fat deposition, and the earlier emergence of metabolic diseases.
According to the editorial in the journal Diabetes and Metabolic Syndrome: Clinical Research and Reviews, BMI serves as an inadequate gauge for obesity. It advocates shifting emphasis from generalized obesity to abdominal obesity, moving beyond reliance on BMI to prioritize waist circumference and indices like the waist-to-height ratio for precise cardiometabolic risk assessment in everyday clinical settings.
Data from the National Family Health Survey-5 indicates that abdominal obesity impacts about 40% of women and 12% of men. Notably, it is no longer limited to urban or affluent groups; rates are climbing in rural areas and among lower and middle socioeconomic strata.
