Reframing obesity may end the diagnosis debate, but the health challenges remain

Obesity is one of the world’s biggest health challenges, causing a mass of shorter, unhappier lives and a mounting burden on already overstretched healthcare systems.There is no doubt that more people than ever before are living with excess body fat, and there is no doubt about the dangers of doing so. Obesity has the ability to harm every single organ in the body, and increases the risk of type 2 diabetes, heart disease, cancer and mental illness.But at the same time, the idea of obesity as a disease itself has been at the centre of one of the most controversial and polarising debates in modern medicine. The row is rooted in the fact that while some people may tick the box of being obese, currently determined as having a body mass index (BMI) over 30, they show no signs or symptoms of ill health, and their organs are in perfect working order

Call to overhaul obesity diagnoses amid fears of over-reliance on BMI

Doctors are proposing a “radical overhaul” of how obesity is diagnosed worldwide amid concerns that a reliance on body mass index may be causing millions of people to be misdiagnosed.More than 1 billion people are thought to be living with the condition that for decades has been diagnosed by measuring a person’s BMI (their ratio of height to weight) to estimate the amount of excess body fat they have.However, there are fears BMI on its own is not a “reliable measure” of an individual’s health and may be resulting in both under- and over-diagnosis of obesity, with “negative consequences” for those affected and wider society.Dozens of the world’s leading experts across a broad range of medical specialisms – including endocrinology, internal medicine, surgery, biology, nutrition and public health – are now calling for a “reframing” of the condition that is causing major harm on every continent and costing countries billions.Relying only on BMI is “ineffective” because it is not a direct measure of fat, fails to reflect fat distribution around the body, and does not provide information about a person’s health, according to a report published by the experts in the Lancet Diabetes and Endocrinology journal

UK women share their experiences of using fertility-tracking apps

After 15 years on the contraceptive pill Francesca* decided that she wanted to know how her body felt without additional hormones. She started using a fertility tracking app – which tracks menstrual cycles or symptoms of ovulation to help estimate a woman’s fertile window – after learning about them on social media.“I had been taking hormones since my teens, and had no real conception of my menstrual cycle in my adult life,” said the Londoner, now in her early 30s. She had been diagnosed with polycystic ovary syndrome (PCOS) at 18 and told to continue taking the pill to help with symptoms. “Remarkably, pretty much all of my hormonal imbalance symptoms started to subside after stopping taking the pill,” she said

Keeping Gaie Delap in jail is a travesty of justice | Letters

Zoe Williams does well to highlight the absurdity of Gaie Delap’s case (This 77-year-old climate activist should never have been jailed – and now faces a Kafkaesque struggle to get out, 9 January). Recalling a 78-year-old woman convicted of a non-violent, peaceful protest to prison on a technicality makes a mockery of our justice system.Irrespective of opinions on Delap’s activism and actions and whether she should have been given a custodial sentence in the first place, it’s clear that she has been unfairly punished by an electronic tag system that is unfit for purpose, and a judicial process that is farcically failing. And this should be of significant concern to James Timpson, the prisons minister and the chair of the recently announced Women’s Justice Board – a board that will have a remit to reduce the number of people in prison and make innovative use of technological solutions in community sentencing.The use of electronic tagging is problematic and can be stigmatising

Scientists find hundreds more genetic risk factors for depression

A global study has identified 300 previously unknown genetic risk factors for depression because it included a much wider population sample.According to the World Health Organization, 3.8% of the population has depression at any one time, affecting about 280 million people.While a range of factors including adverse life events, physical ill health and stress can increase the risk of developing depression, it also has a genetic component.An international team of researchers, led by the University of Edinburgh and King’s College London, studied anonymised genetic data from more than 5 million people in 29 countries, with one in four from non-European ancestries

NHS trust admits liability for doctor who sexually abused patients

A hospital trust has admitted liability for the actions of a doctor found to have used invasive and intimate procedures on patients for sexual gratification.Dr Iuliu Stan, who worked for the Royal Cornwall hospitals NHS trust between 2015 and 2020, was found by a tribunal to have subjected a number of patients to “unnecessary” use of rectal medication for men and boys.A misconduct hearing held last year was told Stan inappropriately prescribed and administered rectal medication without obtaining informed consent, offering a chaperone or providing alternative options.The tribunal found that Stan’s behaviour was “sexually motivated in relation to multiple patients”.In statement, the Royal Cornwall hospital said: “We have written to affected individuals to admit liability for the actions of Dr Stan and to offer an unreserved apology to victims