How to Define Obesity? Evidence-based Multiple Action Points for Public Awareness, Screening, and Treatment: an Extension of Asian-Pacific Recommendations

Metabolic risks are greater in Asians than Caucasians at a given body mass index (BMI). It is generally accepted that the BMI cut-off points for defining overweight and obesity should be lower for Asians. However, the percent body fat at a given BMI and metabolic responses to fatness vary among the different ethnic groups in Asia. Therefore, roughly even-spaced multiple action points (i.e., BMIs of 23, 25, 27.5, 30, 32.5, 35 and 37.5) have been advocated for managing obesity in Asians. We propose here evidence-based ethnicity-specific action points for public awareness, screening, and treatment that take into consideration sensitivity, specificity, and positive/negative predictive values for cardiovascular disease and/or metabolic syndromes, which are the most preva-lent adverse consequences of obesity.