Review of Body Shape and Size Index and obesity insights from recent studies in Pakistan
Keywords:
obesity; Body Shape and Size Index (BSSI); body mass index (BMI); public health; anthropometric measurements; quantile regression (QR); health outcomes; obesity assessment toolsAbstract
Obesity has emerged as a significant public health crisis globally, with its prevalence rising at an alarming rate across various demographics. Characterized by excessive fat accumulation, obesity is associated with numerous health complications, including cardiovascular diseases, type 2 diabetes, and certain cancers, along with mental health issues such as anxiety and depression. In Pakistan, the situation is particularly critical; studies indicate that adult obesity rates have increased from 21% in 2016 to 29% in 2024, while childhood obesity has surged from 9% to 19% over the same period. These trends highlight the pressing need for effective obesity assessment strategies and targeted public health interventions to mitigate the impact of obesity on health outcomes in the country. The traditional measure of obesity, the Body Mass Index (BMI), has been widely used due to its simplicity in calculating weight relative to height. While BMI provides a quick classification of individuals as underweight, normal weight, overweight, or obese, it has inherent limitations. BMI fails to consider variations in body composition, fat distribution, and demographic factors such as age, gender, and ethnicity. Reliance solely on BMI may lead to misclassification of individuals’ health risks, undermining the effectiveness of obesity management strategies. There is a growing recognition for alternative measures, including the Body Shape and Size Index (BSSI), which accounts for multiple anthropometric variables to provide a more comprehensive assessment of obesity and its associated health risks. This review focuses on methodological advancements in the field of obesity assessment, specifically the evolution of BSSI, and synthesizes findings from recent studies conducted in Pakistan. Drawing on data from diverse populations, these studies highlight the potential of BSSI to improve obesity risk stratification by integrating measurements such as body surface area (BSA), weight, and height. The use of quantile regression (QR) techniques to create growth charts for BSSI enhances understanding of body composition across different age groups and genders, offering valuable insights for public health policy formulation. The implications of these findings underscore the importance of integrating BSSI into national health monitoring systems and public health initiatives, which could lead to more effective obesity prevention and management strategies tailored to the unique characteristics of Pakistani populations. Implementing innovative assessment tools like BSSI is crucial for addressing the pressing public health crisis of obesity and improving health outcomes in diverse communities.
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