AACE MENA 2025-Beyond BMI: The Role of Body Composition Assessment in Obesity Pharmacotherapy

Beyond BMI: The Role of Body Composition Assessment in Obesity Pharmacotherapy

Video Transcription

Video Summary

Dr. Tarek Shoukair discusses moving beyond BMI in obesity assessment, emphasizing body composition analysis to better identify excess adiposity and cardiometabolic risk, especially in individuals with BMI under 30 where BMI may miss high fat percentage. He highlights limitations of BMI, including inability to differentiate fat from muscle and fat distribution. Advanced methods like DEXA and bioelectrical impedance analysis (BIA) aid detection, though not always feasible in clinics. During weight loss, about 25-30% of weight lost is lean mass, but newer obesity medications like semaglutide show favorable body composition changes and improved muscle strength without increasing sarcopenia risk. Protein intake and resistance training are crucial to preserving lean mass. Body composition tracking during weight loss identifies excessive lean mass loss for early intervention. While promising, Dr. Shoukair notes the need for more research on population-specific cutoffs and practical implementation in various clinical settings to optimize obesity management beyond BMI.

Keywords

BMI limitations

body composition analysis

DEXA

bioelectrical impedance analysis

obesity medications semaglutide

lean mass preservation