Abstract
Obesity is defined by the World Health Organization (WHO) as a body mass index (BMI) ≥ 30 Kg/m2. This study aimed to test the validity of this BMI cut-off point for adiposity in a weight management clinical setting in Lebanon. This cross-sectional study of 442 adults of mixed gender, categorized by the WHO BMI classification, included: 66 individuals of normal weight, 110 who were overweight and 266 with obesity. The clinical sample was referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon. All participants underwent anthropometric evaluation. The gold standard for defining obesity was based on the National Institutes of Health (NIH)/WHO guidelines for total body fat percentage (BF%). The best sensitivity and specificity were attained to predict obesity, according to the receiver operating characteristic curve (ROC) analysis. The BMI cut-off point for predicting obesity in the clinical sample was nearly 31.5 Kg/m2, and more than 90% of individuals with obesity and cardiometabolic disease were above this cut-off point. In conclusion, this new BMI cut-off point, an obesity definition higher than suggested in Western populations, was demonstrated to have clinical usefulness. Obesity guidelines in Lebanon, therefore, need revising.
Highlights
Obesity is a growing health problem, with prevalence increasing continually worldwide [1]
The gold standard for defining obesity was based on the National Institutes of Health (NIH)/World Health Organization (WHO) guidelines for total body fat percentage (BF%)
The World Health Organization (WHO) defines obesity as an excessive fat deposition in the adipose tissue [9,10]; the classification of adiposity based on body fat (BF) quantification and assessment seems to be the most accurate [11]
Summary
Obesity is a growing health problem, with prevalence increasing continually worldwide [1]. To classify obesity in adults, the WHO mainly relies on a body mass index (BMI) cut-off point that has been derived mainly from Western populations (i.e., Europeans); a BMI ≥ 30 Kg/m2 indicates obesity [9]. This cut-off point is widely used in clinical and research settings to define obesity, since it is considered a simple and cheap tool for assessment [12], especially because it is highly correlated with BF [12]. Public Health 2020, 17, 3832; doi:10.3390/ijerph17113832 www.mdpi.com/journal/ijerph
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