Redefining Obesity: Moving Beyond BMI to Focus on True Health

Obesity has been a growing problem in Australia for years, particularly among children. To effectively address the issue, a shift in how we understand and manage the condition is vital.

A Commission realised in January 2025 by The Lancet medical journal proposes reclassifying obesity not as a risk factor, but as a stand-alone disease. This marks a significant change in how we approach prevention and early intervention.

This article explores what the latest research into obesity means for families, why moving beyond BMI matters, and how focusing on true health can help support children before weight management becomes a lifelong struggle.

Summary of The Lancet Commission’s reclassification

The Lancet Commission redefines obesity as a disease that progresses through two stages:

Preclinical obesity

Preclinical obesity relates to excess body fat without any current health issues.

Clinical obesity

Clinical obesity involves measurable health conditions like high blood pressure, diabetes or mobility issues due to carrying excess weight.

The new Lancet classification shifts the focus from appearance or weight to actual health status, encouraging earlier, more personalised intervention and reducing the stigma tied to body size.

Why this matters

Recognising obesity as a disease rather than a risk factor allows earlier, more targeted action. By identifying preclinical obesity, healthcare professionals can look beyond BMI and act before more serious health complications arise.

A proactive approach to dealing with the problem supports better outcomes over the long-term. It also reduces the burden of chronic disease and encourages compassionate, evidence-based care over stigma or blame.

Implications for preventing childhood obesity

There are several factors in early life for children that can influence the risk of developing obesity long before clinical signs are present. These include:

Diet
Physical activity
Sleep
Family health history

The Lancet Commission emphasises the need to look beyond BMI (body mass index) alone and identify early warning signs like:

Behavioural cues
Metabolic markers
Rapid weight gain

If intervention happens before reaching BMI thresholds, it allows for more effective obesity prevention in children, helping them build healthy habits and avoid any long-term health issues.

Reducing stigma and shifting the narrative

By redefining childhood obesity as a disease rather than a result of poor health choices, it helps shift the focus from blame and shame to support. This reclassification recognises the complexities of genetic, biological, environmental and social factors that contribute to weight gain.

For children and their families, this means you can access compassionate, non-judgemental care that focuses on health and not appearance. It encourages a more inclusive approach where early support and education take priority over shame. This empowers families to take proactive steps without fear of stigma or blame.

The role of healthcare providers in early obesity intervention

Healthcare providers can play a critical role in early obesity intervention and prevention, especially as obesity is now seen as a disease rather than a risk factor. By adopting a comprehensive approach, medical professionals can identify obesity risks early, even before a child reaches BMI thresholds.

Paediatricians, general practitioners and allied health professionals can integrate the Lancet Commission’s reclassification into their practices, using it as a framework to guide early interventions.

Rather than focusing solely on weight or BMI, healthcare providers should assess a child’s overall well-being and take genetic predispositions, environmental influences and lifestyle factors into account. This holistic view can help in identifying at-risk children before obesity develops into a more complex, clinical condition.

Practical tips for parents and educators

Supporting children’s health doesn’t have to mean solely focusing on weight. Instead, it’s more about creating a positive, balanced environment where healthy habits become a natural part of daily life. Here are some tips:

Encourage regular physical activity through play, family walks or sporting activities your child enjoys. Don’t make it about “burning calories”.
Involve children in meal planning and preparation to build a healthy relationship with food and teach lifelong skills.
Prioritise consistent routines, sleep and screen time limits, all of which contribute to emotional and physical well-being.

Equally important is the language you use at home and school. Avoid labelling foods as “good” or “bad,” and steer clear of comments on weight or body size. It’s also important to focus conversations on how food fuels the mind and body for learning and play, and how movement helps kids feel strong and energised.

By reinforcing a child’s self-worth and resilience and encouraging open communication, parents and educators can help children build confidence and healthy habits without fear or shame.

Take action now for a healthier future

At Childhood Obesity Prevention, we are dedicated to helping families combat childhood obesity through early intervention, education and support. Together, we will foster healthier habits, reduce stigma and create a positive, lasting impact on your child’s well-being.