Review Article

Defining and Diagnosing Obesity in India: A Call for Advocacy and Action

Table 3

Obesity classification in different regions of the world.

AgeIndicatorNormal weightOverweightObeseReference

Adults
International≥20 yearsBMI (kg/m2)18.5–25.99≥25.00≥30.00Weir C. B., et al. BMI classification percentile and cut-off points. Treasure Island (FL): StatPearls publishing; 2023 Jan
Pre-obese: 25–29.99Class 1: 30.00–34.99
Class 2: 35.00–39.99
Class 3: ≥40.00
South Asia≥20 yearsBMI (kg/m2)>23.4>25.2≥26.6Weir C. B., et al. BMI classification percentile and cut-off points. Treasure Island (FL): StatPearls publishing; 2023 Jan
Indian Consensus Group 2009≥20 yearsBMI (kg/m2)23–24.9≥25Misra A, et al. J Assoc physicians India. 2009; 57 : 163–170
ESI 2022≥18 yearsBMI (kg/m2)18.5–22.923–24.9Obesity grade 1: 25–29.9Madhu S. V., et al. Indian J endocrinol metab. 2022; 26 : 295–318
Obesity grade 2: 30–34.9
Obesity grade 3: >35
Clinical Practice Guidelines, Singapore≥18 yearsBMI (kg/m2)18.5–24.925.0–29.9 (pre-obese)Obese class I: 30–34.9Clinical practice guidelines-obesity. Health promotion board, Singapore. 2016
Obese class II: 35–39.9
Obese class III: ≥40
Ministry of Health Malaysia, Malaysian Endocrine and Metabolic Society, Malaysian Association for the Study of Obesity, and Malaysian Diabetes Association≥18 yearsBMI (kg/m2)18.5–22.9≥23Pre-obese: 23–27.4Clinical practice guidelines management of obesity, 2nd edition, 2023. Malaysia health technology assessment section
Obese I: 27.5–34.9
Obese II: 35–39.9
Obese III: ≥40

Children
WHO 20060–60 monthsBMI Z or WH Z>-2 to ≤2 SD>2 to ≤3 SD>3 SDGuideline: assessing and managing children at primary health-care facilities to prevent overweight and obesity in the context of the double burden of malnutrition: updates for the integrated management of childhood illness (IMCI). Geneva: World Health Organization; 2017
At risk of overweight: >1 to ≤2 SD
WHO 20075–19 yearsBMI Z>−2 to ≤1 SD>1 to ≤2 SD>2 SDWHO. BMI-for-age (5–19 years). Accessed on 1st September 2023 from https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age
International Obesity Task Force2–18 yearsGrowth curve for BMI at age 18BMI = 25BMI = 30Cole T. J., et al. BMJ. 2000; 320 : 1240-1243
USA2–19 yearsBMI percentile≥5th to <85th≥85th to <95th≥95thHampl S. E., et al. Paediatrics. 2023; 151: e2022060640

BMI, body mass index; EOSS, Edmonton Obesity Staging System; ESI, Endocrine Society of India; WHO, World Health Organization; WHZ, weight-for-height z-score; SD, standard deviation.