An outdated BMI system could be leaving people from ethnically diverse backgrounds at higher risk from type 2 diabetes.

A study has found that the BMI (body mass index) system has outdated cut-offs, meaning people from diverse backgrounds are more likely to develop the disease at a much lower BMI than those from white backgrounds.

The study analysed the health records of 1.5 million adults in England who were registered with a UK GP between 1990-2018.

Researchers have called on the NHS to adopt ethnic-specific obesity cut-off points to make sure people from ethnically diverse backgrounds are being checked early enough to spot the disease.

The study’s principal investigator Dr Rishi Caleyachetty, a junior doctor and epidemiologist at the University of Warwick, said: “As a doctor, I’m extremely concerned that if the current BMI values are not amended to account for ethnicity, many BAME people will needlessly slip through the net, leaving them unknowingly at risk of type 2 diabetes.

“I meet people from BAME backgrounds who tell me about the lack of information on what a healthy weight is for their community.

“Another person, who had been told they were at high risk of developing type 2 diabetes, told me he was surprised because he was not ‘fat’.

“These are just two examples from many cases, indicating that a ‘blanket’ set of BMI values could be disadvantaging BAME people from accessing services to prevent type 2 diabetes.”

He added: “We hope that this study will swiftly kickstart a review of current BMI policy in the UK for BAME people, in order to prevent both type 2 diabetes, and facilitate early and effective treatment of type 2 diabetes.

“We all know the NHS was founded on the principles of fairness and that all patients regardless of their background should be cared for equally, but it is clear at the moment these principles may not be a reality for many BAME people.”

According to NHS guidelines, an adult with a BMI of 30kgm-2 or above is obese, a point at which action would be taken to prevent type 2 diabetes.

But the study found that the cut-off points were much lower for people who were not from a white background: for South Asians, it was 23.9; for Chinese people, it was 26.9; for black people it was 28.1; and for Arabs it was 26.6.

A co-investigator on the study, Dr Paramjit Gill, professor of general practice and head of the division of health sciences at the University of Warwick, said: “This work highlights that we need evidence for all ethnic groups as they are at risk of diabetes at different levels of BMI.

“A blanket approach is not acceptable any longer.”

The study was funded by the National Institute for Health Research and undertaken by four UK universities in partnership with the Ethnic Forum.

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