On January 14, 2025, The Lancet Diabetes & Endocrinology published a report by 58 experts calling for a shift from BMI to more accurate measures of obesity, such as waist-to-height ratios and direct body fat measurements (Rubino et al., 2025).
Why We Have To Look Beyond BMI
For decades, BMI has been the go-to measure for identifying obesity, but BMI has significant limitations. BMI is based on height and weight, so doesn’t account for crucial factors like muscle mass, fat distribution, and overall body composition (Nuttall, 2015). This can lead to misleading outcomes, where individuals with high muscle mass are labeled as overweight or obese, while others with unhealthy levels of visceral fat might fall within the “normal” BMI range.
Recognising these limitations, The Lancet Commission report advocates for more accurate measures to assess clinical obesity. It highlights metrics like waist-to-height ratios and direct body fat measurements, to provide a better picture of an individual’s health.
Clinical vs. Preclinical Obesity
One of the most notable contributions of the report is its distinction between two types of obesity:
Clinical Obesity: Characterised by excess body fat that has already resulted in health complications such as type 2 diabetes, heart disease, or other metabolic conditions.
Preclinical Obesity: Refers to individuals with excess fat but no current health issues. Identifying this group is essential for early interventions to prevent future complications.
This refined classification system offers a more targeted approach to healthcare, enabling personalised treatments and preventative strategies.
Global Significance
Endorsed by 76 organisations worldwide, the report underscores the urgent need for a paradigm shift in how we diagnose and address obesity. With obesity rates rising globally, these recommendations have the potential to influence public health policies and medical practices on an international scale (The Lancet, 2025).
The Role of Body Volume Index (BVI)
A key contribution to this evolving conversation is the Body Volume Index (BVI), a technology designed to assess body composition more accurately than BMI. BVI considers factors like visceral fat levels, body fat percentage, and waist-to-hip ratios, offering a more comprehensive understanding of an individual’s health (Barnes, 2022).
In October 2022, Richard Barnes, founder of the BVI initiative, presented this innovative tool to 80 authors of The Lancet report. The publication itself acknowledges this presentation in their report. Richard Barnes states “We have to move on from BMI which measures total weight only. The Body Volume Index measures where the weight is, which is why it’s such an advancement, and I’m excited about BVI’s potential role in transforming obesity assessments."
What This Means for the Future
The Lancet report marks a significant step toward redefining obesity measurement and management. Moving away from the simplicity of BMI to more sophisticated metrics like BVI and waist-to-height ratios will allow healthcare providers to offer more personalised and effective interventions. For individuals, it’s an opportunity to better understand their health and make informed decisions based on a fuller picture of their body composition.
As the world embraces this new approach, tools like BVI stand ready to lead the charge, bridging the gap between scientific innovation and practical application. Together, we can move toward a future where health is measured not just by numbers, but by a deeper understanding of the body and its needs.
Call to Action
To find out more about how BVI is transforming the world of body measurements visit www.bodyvolume.com If you’re an individual who wants to know more about your body composition then download the mybvi app on your smartphone.
Reference List
Barnes, R. (2022, October). BVI: A new approach to body composition measurement. Presented to The Lancet Commission authors.
Nuttall, F. Q. (2015). Body mass index: Obesity, BMI, and health: A critical review. Nutrition Today, 50(3), 117-128.
Rubino, F., et al. (2025). Reassessing obesity: Moving beyond BMI to improve health outcomes. The Lancet Diabetes & Endocrinology.
The Lancet. (2025). The Lancet Commission report on obesity. The Lancet Diabetes & Endocrinology.
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