Tag: obesity

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Tether thy liver

There are few of us who take our liver seriously. Yet, this big organ plays a central role in our body to regulate metabolism. The obesity pandemic in western countries increases health risks, just as excessive alcohol consumption increases risks of liver dysfunction. Additionally, viruses increase the risk of failure of this organ.
Each of these risks as well as any combination of one of the risks with another one have led to rising public health risks. Several studies since 2020 have highlighted these increased risks for populations in general. The risks, however, have an unequal spread across subgroups of society. A recent comment based on the research of the INSERM U955 team in “The Lancet Regional Health” by Brustia et al. “Liver-related mortality strikes hardest where deprivation is greatest.” Health inequities consist in the lack of income available to buy healthy food or in untreated alcohol addiction, both more common in poor people.
In order to tackle the inequity, the team of medical doctors call for a shift in awareness. Structural reasons like diagnostic delay, remoteness or health literacy are just as important as individual predilections like nutrition or lifestyles. Inequality in access to health and ability to afford a healthy lifestyle have become serious drivers of social inequality in the 21st century.

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Less but better

There are many examples where a new mantra for the 21st century emerges from recent scientific evidence: “Less, but better” (Lbb). In studies of nutrition and human dietary requirements, the importance to eat less has been demonstrated on a regular basis. And this is even more important than to do more exercise if weight loss is the target or the attempt to explain obesity across the globe (McGrosky et al. 2025). The case for eating less is strong. Eating better refers to the need to avoid unhealthy, toxic or cancerous food or the way to prepare food. “Less but better” could become the new mantra or “categorical imperative” if you like it more philosophical in tone. We, the people gain, and the planet will gain as well. It is an easy win-win case, albeit with some behavioral implications.

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Obesity Revised

The scientific paper on a revised definition of obesity was produced by the special Commission on Obesity. It appeared in The Lancet Diabetes & Endocrinology in 2025-1. The previously common practice by medical doctors was to classify person in the obesity category based mainly on the simple calculation of the body mass index (BMI = weight/height²). A BMI  > 30 put persons into the obese category and stigma.
Since the Covid-19 society-wide testing experience, we are all familiar what it means if you get misclassified and have to live with the consequences (exclusion from work or events etc.). The simplifying and summarizing BMI calculation and classification has also produced many wrong classifications. For example, persons with a lot of muscles (just watch this at any fitness studio) will have a high weight relative to their body height², but they are likely to be more healthy than many other light weight, but seriously stressed persons.
In empirical test theory such cases are the so-called false positive cases, i.e. classified as obese, but not a medical problem at all. Medical doctors and health insurances should not finance special treatments for these persons, which foregoes treatment of other more needy persons.
With new expensive drugs on the market to treat obesity it is even more important to test with more precision the normal, pre-clinical and clinical status of obesity. Fatty tissue or muscles, that is the relevant question. Fatty tissue in muscles is the next level testing issue.