Rinki Murphy: Endocrinologist on the recommendations regarding the diagnosis of obesity

An overhaul of how obesity is diagnosed could be on the way. 

The Global Commission on Clinical Obesity has made recommendations that diagnosis is focused on measures of total body fat, not just BMI. 

The paper says current practices rely too heavily on body-mass indexes. 

Endocrinologist Rinki Murphy told Tim Beveridge it won't mean people can just diagnose obesity by standing in front of the mirror. 

She says it becomes unhealthy when fat goes into organs, and it's not able to be seen by the bare eye.  

The Global Commission on Clinical Obesity also recommends recognising two categories of obesity. 

Clinical obesity would be used for cases where excess body fat is negatively affecting body functions, while pre-obesity is where a patient has excess fat but it's not having consequences yet. 

Murphy says BMI will still need to be used for population data. 

She says it's required for monitoring, while the two categories can be used on an individual level. 

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Episode Transcript

Speaker 1 (00:09):
You're listening to a podcast from newstalk ZEDB. Follow this
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Speaker 2 (00:17):
Yes.

Speaker 3 (00:18):
And a global commission of medical experts wants to redefine
who should be considered obese, saying that we should no
longer use just the BMI the body mass index because
it risks over diagnosis. Instead, it's where you carry fat
that matters. They say it's important to look at a
person's waist circumference, body fat and organ health as well.
Professor Rinky Murphy is an endocrinologist and clinical head of

(00:41):
specialist weight Management service to mana Quita and she joins me, now.

Speaker 2 (00:47):
Hello, hello, Cura.

Speaker 3 (00:50):
Yeah, curer, I thought we'd known this for a long time.
I've had plenty of nutrition to say. Our BMIs allowsy
way to measure obesity.

Speaker 2 (00:59):
Yeah, that's true, but there has been variation and whether
people do go to the trouble of defining obesity more carefully.
And what this paper does is just amplifies that message
that you can't just rely on BMI and that you
need these other measures. And moreover, not everybody has the
more severe end of obesity that's more akin to a disease.

Speaker 3 (01:22):
Now, what if you trivialize it, are we almost better?
You get more from looking in the mirror than measuring
your and then looking at your weight and height.

Speaker 2 (01:30):
It can be quite the same when you look at
yourself from the mirror and where you can kind of
testigonize ourselves or other people can judge whether you're carrying
excess body fat. But what's important is if you carry
it under the skin. That's quite a safe and effective
way to carry away fat. And what's not healththare is
when it goes into your organs and you can't really
look in the mirror and when it's affecting.

Speaker 3 (01:51):
Organs, will it change our obesity statistics? Do you think?

Speaker 2 (01:56):
Well? I think at a population level will have to
rely on b. Devin just in terms of monitoring and
an nuances of who's got the clinical OBC in versus
pre clinical will need some more detailed investigation level.

Speaker 3 (02:09):
What about this distinguishing between clinical obesity and pre clinical
how does that differ?

Speaker 2 (02:15):
Yeah, so clinical obesity is now defined as somebody who's
functioning limited by obesit or exx body sent all of
the organs are affected, and there has to be some
significant organs that are affected, and there's a list of
them and how to categorize them either through signs or
symptoms or tests. In that way, we can really focus

(02:37):
our sort of treatment strategies on the people with clinical obesity,
who are living with the more severe end.

Speaker 3 (02:47):
Be treating obesity like a disease enough, because I think
doctors treat it like a disease disease, But did New
Zealander see it as such?

Speaker 2 (02:56):
Well, it's it's quite variable, and I think there are
some people who will be pleased by not being in
the obesity classification by these guidelines. So if you're living
well with high body weight, you're not significantly affected and
neither of your organs and you've got pre clinical obesity,

(03:17):
and there's a different type of conversation around reducing your risk,
whereas once you're in that conquort bc END hopefully improve
access to treatment, more effective competensive treatments including medications and
er actric surgery and the pers thing.

Speaker 3 (03:35):
There's a lot of talk around things like a zempic.
Do you worry about social media's obsession with the latest
pill to deal with these things?

Speaker 2 (03:43):
Well, in some taxes, if it's not used appropriately, it
can cause an issue, But we have to remember how
effective these are and how important they are to be
accessed by people who've got a kind of OVC end.
They are more effective than any other medication that we've had.
You know, you're almost becoming as effective as bariatric surgery,

(04:05):
and it's really important that people who need them can
get them. And this is one way of really defining
who is most affected.

Speaker 3 (04:14):
Yeah, Hey, I really appreciate your time this morning, Rinky.
There's a professor Rinky Murphy who is an endocrinologist and
clinical head of a specialist waite management service to monarquetur
for more from.

Speaker 1 (04:24):
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