目前肥胖的诊断标准基于体质量指数（BMI），但该指数不能直接反映脂肪的蓄积，也不能体现对健康产生的不良影响，因而不能满足临床需求。基于此背景，柳叶刀杂志糖尿病与内分泌委员会对肥胖进行重新定义，将仅具有人体测量学指标的异常定义为临床肥胖前期，仅需生活方式干预，以改善人体测量学异常，降低疾病风险；而同时合并肥胖直接导致的疾病和日常活动能力受限，定义为临床肥胖症，需要积极进行医学干预。尽管个别专业学会质疑该定义和诊断标准有可能将部分肥胖从疾病状态划归为风险因素，而使病人失去潜在治疗机会，然而整体上，该标准基于脂肪蓄积及其对器官功能的影响，因而对于肥胖的精准诊疗更具积极意义。

The current diagnostic criteria for obesity are based on body mass index (BMI). However, BMI does not directly reflect fat accumulation or its adverse health effects, making it inadequate for clinical needs. In response, the Lancet Diabetes & Endocrinology Commission has proposed a refined definition and diagnostic criteria of obesity, including Pre-clinical Obesity which is defined as having only abnormal anthropometric indicators, thus only lifestyle interventions is recommended to improve body composition and reduce disease risk; as well as Clinical Obesity which is diagnosed when abnormal anthropometric indicators are accompanied by obesity-related comorbidities or limitations in daily activities, necessitating active medical intervention. While several academic societies have raised concerns that this classification may reclassify some obesity cases from a disease state to a risk factor, potentially depriving patients of treatment opportunities, the new criteria overall represents a significant advancement in enabling more precise diagnosis and management of obesity, based on fat accumulation and its impact on organ function.