A Nature study involving a Spanish co-lead strengthens a point Spain’s health system should not treat as a technical footnote: BMI can sort bodies, but it does not by itself describe clinical risk well enough. The proposed approach combines BMI with measures such as waist circumference, fat distribution and organ function to distinguish clinical from preclinical obesity.
El Mundo reports that the research assessed a framework proposed in 2025 by The Lancet Diabetes & Endocrinology Commission in 844,108 adults in China, the United Kingdom, the United States and Spain. Adding measures to conventional BMI assessment improved obesity identification by 3.3% to 7.4%, according to the report, and allowed researchers to separate active disease from a condition that may call for preventive follow-up based on individual risk.
The Catalan result shows why the shift matters in practice. José Manuel Fernández-Real, a researcher linked to the study, said that adding waist circumference and waist-to-height ratio to BMI in the SIDIAP population raised identified obesity prevalence from 18.7% to 26.1%. That does not mean those people suddenly developed a new disease. It means the earlier screen may have missed people whose fat distribution or organ impact warranted a different clinical assessment.
The sensible consequence is not to turn every extra measurement into an automatic label. The framework itself distinguishes clinical from preclinical obesity: not everyone in the latter group should be treated as having active disease. But BMI should not be presented as a sufficient verdict when it leaves out body composition, visceral fat and organ function.
The main challenge is organisational. Fernández-Real said the change would initially mean more work in primary care, but work better focused on people who need it most. The available material does not show that Spain has adopted the framework, nor does it set out funding, clinical thresholds or implementation rules. Still, the study shifts the relevant question from counting kilograms to assessing harm and risk more precisely.
Sources
- El Mundo · Source date: 2026-11-11
Independent editorial content. WUA is not affiliated with any political party. 2026-11-11