{"id":4053,"date":"2026-01-14T18:32:03","date_gmt":"2026-01-14T23:32:03","guid":{"rendered":"https:\/\/coattitude.com\/?p=4053"},"modified":"2026-01-14T18:39:11","modified_gmt":"2026-01-14T23:39:11","slug":"mesures-medecine-obesite-au-dela-imc","status":"publish","type":"post","link":"https:\/\/coattitude.com\/en_ca\/mesures-medecine-obesite-au-dela-imc\/","title":{"rendered":"Useful measures for obesity medicine"},"content":{"rendered":"
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How to<\/span> integrate, in addition to BMI, new and useful indices for better treatment of obesity<\/span><\/strong><\/h2>\n

Obesity is a disease in which fat deposits, called adiposity, are detrimental to health.<\/span><\/p>\n

In 2024, a study published in <\/span>The Lancet<\/a><\/span> showed that <\/span>43 % of adults are overweight<\/span>. In 2025, the director of\u2019World Health Organization<\/a> said that obesity, recognized as a chronic disease, is one of the major public health challenges worldwide. According to the WHO, an adult is considered obese when his or her body mass index (BMI) exceeds 30.<\/span><\/p>\n

The WHO definition now incorporates new measures, as do the recommendations of Obesity Canada, to better define the disease and its real impact on health. Waist circumference, when combined with BMI, enables a more precise diagnosis. Other tools also enable us to better target the location of fat, a key determinant of health risk.<\/span><\/p>\n

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Obesity: a disease that's about more than weight<\/span><\/h2>\n

Scientific data clearly show that <\/span>weight loss alone is not enough to improve health<\/span> of people living with obesity. Medical management should focus on diet, avoiding restrictive diets, regular physical activity, mental health and visceral fat reduction.<\/span><\/p>\n

Weight loss can, however, improve certain symptoms. Osteoarthritis of the knees and walking difficulties generally improve with weight reduction. In addition, about <\/span>50 % of people with sleep apnea<\/span> after weight loss.<\/span><\/p>\n

It is important to note that <\/span>29 % of obese people have normal biological and physical indicators<\/span>, such as blood pressure or blood tests within the reference values.<\/span><\/p>\n

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Medical measures useful for diagnosis and follow-up<\/span><\/h2>\n

Today, several indicators are used to diagnose obesity, support weight management and monitor disease progression. These include BMI, waist circumference and waist-to-waist ratio, as well as more advanced tools such as lipodensitometry and impedancemetry.<\/span><\/p>\n

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Body mass index (BMI)<\/span><\/h2>\n

The body mass index has been around since the 1800's. It was originally developed for statistical analysis of populations and to characterize their morphology. BMI corresponds to weight in kilograms divided by height in meters squared.<\/span><\/p>\n

A BMI greater than or equal to 25 corresponds to overweight, while a BMI greater than or equal to 30 defines obesity according to this indicator alone. Early studies showed that the higher the BMI, the greater the risk of complications. A study published in 2013 showed that people with a BMI of grade 2 or 3 have a higher risk of <\/span>mortality risk more than 30 % higher<\/span> compared to people with a lower BMI.<\/span><\/p>\n

The same study suggested that overweight people could sometimes present a lower risk than those with a so-called normal BMI, possibly due to closer medical monitoring.<\/span><\/p>\n

However, BMI should be interpreted with caution. It does not take into account the distribution between muscle mass, bone mass and fat mass. It is particularly unsuitable for athletes and short people. For example, a person measuring 1.90 m and weighing 110 kg would have a BMI of around 30, even though their muscle and bone mass account for a large proportion of their weight. BMI is therefore unable to distinguish fat weight from muscle weight, which is a major limitation to its use.<\/span><\/p>\n

A study published in <\/span>Nutrients<\/span> shows that the higher the BMI, the greater the <\/span>food dependency<\/span> (25%) compared with those of normal weight (11%). When BMI exceeds 40, this food dependency becomes even more pronounced. The combination of high BMI and food dependency calls for greater attention in the<\/span> care<\/span> due to the <\/span>psychological vulnerability<\/span> larger.<\/span><\/p>\n

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Calculate your BMI easily on our allurion gastric balloon page!<\/u><\/b><\/a><\/span><\/h2>\n

Waist circumference: now an essential indicator<\/span><\/h2>\n

Waist circumference measurement is now systematically added to the diagnosis of obesity. When fat deposits are concentrated in the abdominal area, health risks increase significantly. BMI alone provides no information on the distribution of fat in the body.<\/span><\/p>\n

Abdominal obesity occurs when waist circumference exceeds <\/span>102 cm for men<\/span> and <\/span>88 cm for women<\/span>, outside pregnancy.<\/span><\/p>\n

To measure waist circumference correctly, we recommend using a non-elastic tape measure, placed between the last rib of the thorax and the highest bony point of the pelvis, generally at navel level. The measurement should be taken without drawing in or inflating the belly, and ideally twice, in order to determine the average.<\/span><\/p>\n

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Waist-to-waist ratio<\/span><\/h2>\n

The ratio between waist circumference and waist circumference, expressed in the same unit of measurement, is used to assess the risk of chronic diseases associated with obesity. When this ratio exceeds <\/span>0,5<\/span>, the risk of complications increases.<\/span><\/p>\n

\u00c0 titre d\u2019exemple, une personne ayant un tour de taille de 77 cm pour une taille de 165 cm pr\u00e9sente un rapport de 0,46, ce qui n\u2019augmente pas le risque de maladies chroniques. \u00c0 l\u2019inverse, un tour de taille de 115 cm pour une taille de 175 cm correspond \u00e0 un rapport de 0,657, indiquant un risque accru.<\/span><\/p>\n

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Pourquoi cibler la graisse visc\u00e9rale plut\u00f4t que le poids seul<\/span><\/h2>\n

En m\u00e9decine de l\u2019ob\u00e9sit\u00e9, l\u2019objectif principal est d\u2019am\u00e9liorer la sant\u00e9 globale et de r\u00e9duire les risques de complications telles que les maladies cardiovasculaires, le diab\u00e8te, certains cancers et d\u2019autres maladies chroniques.<\/b><\/span><\/p>\n

Ces am\u00e9liorations sont obtenues en priorit\u00e9 par la diminution de la graisse intra-abdominale. Lorsqu\u2019une personne s\u00e9dentaire perd du poids, cette perte se r\u00e9partit g\u00e9n\u00e9ralement en tiers : un tiers de la couche graisseuse p\u00e9riph\u00e9rique, un tiers de masse musculaire et un tiers de graisse interne. C\u2019est pourquoi le poids reste un indicateur utile, mais doit toujours \u00eatre interpr\u00e9t\u00e9 en parall\u00e8le du tour de taille, qui refl\u00e8te plus directement la graisse visc\u00e9rale.<\/span><\/p>\n

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Le stade d\u2019Edmonton : \u00e9valuer la s\u00e9v\u00e9rit\u00e9 de l\u2019ob\u00e9sit\u00e9<\/span><\/h2>\n

Le stade d\u2019Edmonton est une classification qui permet de caract\u00e9riser la gravit\u00e9 de l\u2019ob\u00e9sit\u00e9 en tenant compte du poids, de la taille, des comorbidit\u00e9s et de la stabilit\u00e9 de la sant\u00e9 physique et mentale. Cette \u00e9chelle va de 0 \u00e0 4.<\/span><\/p>\n

Le stade 0 correspond \u00e0 une situation o\u00f9 l\u2019ob\u00e9sit\u00e9 ne semble pas nuire \u00e0 la sant\u00e9, tandis que le stade 4 correspond \u00e0 une situation de sant\u00e9 instable, comme un diab\u00e8te non trait\u00e9, une hypertension art\u00e9rielle non \u00e9quilibr\u00e9e ou un trouble hyperphagique associ\u00e9 \u00e0 une d\u00e9tresse mentale importante.<\/span><\/p>\n

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Masse grasse et localisation de la graisse corporelle<\/span><\/h2>\n

Chez l\u2019homme, un pourcentage de masse grasse compris entre <\/span>10 et 25 %<\/span> est consid\u00e9r\u00e9 comme normal. Chez la femme, selon l\u2019\u00e2ge, ce pourcentage varie g\u00e9n\u00e9ralement entre <\/span>20 et 35 %<\/span>. Au-del\u00e0 de ces valeurs, l\u2019exc\u00e8s de graisse peut devenir nuisible, en particulier lorsqu\u2019il se situe au niveau abdominal et visc\u00e9ral.<\/span><\/p>\n

La graisse localis\u00e9e aux membres inf\u00e9rieurs et sup\u00e9rieurs est beaucoup moins d\u00e9l\u00e9t\u00e8re pour la sant\u00e9 que la graisse abdominale.<\/span><\/p>\n

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Lipodensitom\u00e9trie et imp\u00e9dancem\u00e9trie<\/span><\/h2>\n

La lipodensitom\u00e9trie, aussi appel\u00e9e absorptiom\u00e9trie \u00e0 rayons X \u00e0 double \u00e9nergie (DXA), permet d\u2019analyser avec pr\u00e9cision la masse musculaire, la masse osseuse et la masse adipeuse, ainsi que leur localisation. Cet examen est non invasif, indolore et rapide, mais n\u2019est actuellement pas pris en charge par la RAMQ. Il est recommand\u00e9 de porter des v\u00eatements confortables, de ne pas prendre de suppl\u00e9ment de calcium dans les 24 heures pr\u00e9c\u00e9dant l\u2019examen et de rester immobile pendant quelques minutes.<\/span><\/p>\n

L\u2019imp\u00e9dancem\u00e9trie repose sur la mesure de la r\u00e9sistance \u00e9lectrique des diff\u00e9rents tissus corporels afin d\u2019estimer les proportions de graisse, de muscle et d\u2019eau. Elle n\u2019est pas non plus couverte par la RAMQ, sauf dans certaines cliniques disposant de balances \u00e0 imp\u00e9dance. Dans le programme Allurion, ces balances permettent un suivi pr\u00e9cis et personnalis\u00e9 de la perte de poids, en distinguant ce qui est perdu en termes de graisse, de muscle et d\u2019eau. Ce suivi aide \u00e0 ajuster les choix alimentaires et l\u2019activit\u00e9 physique, notamment lorsque la masse musculaire diminue. Les contre-indications de l\u2019imp\u00e9dancem\u00e9trie sont la grossesse et le port de dispositifs implant\u00e9s comme les pacemakers.<\/span><\/p>\n

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L\u2019\u00e9volution de la graisse avec l\u2019\u00e2ge et le r\u00f4le des hormones<\/span><\/h2>\n

Avec l\u2019\u00e2ge, la localisation de la graisse corporelle tend \u00e0 se modifier. Chez la femme, l\u2019approche de la m\u00e9nopause s\u2019accompagne d\u2019une diminution des hormones f\u00e9minines et d\u2019une accumulation progressive de graisse au niveau abdominal. Cette augmentation du tour de taille entra\u00eene une hausse du risque cardiovasculaire, rapprochant le risque de celui observ\u00e9 chez les hommes.<\/span><\/p>\n

Chez l\u2019homme, la diminution de la testost\u00e9rone lors de l\u2019andropause favorise \u00e9galement l\u2019accumulation de graisse au niveau abdominal et autour des visc\u00e8res.<\/span><\/p>\n

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Muscle, eau corporelle et objectifs th\u00e9rapeutiques<\/span><\/h2>\n

Un kilogramme de muscle est beaucoup plus dense qu\u2019un kilogramme de graisse. Les muscles sont riches en fibres musculaires et en eau. Le corps d\u2019un homme contient en moyenne entre <\/span>50 et 65 % d\u2019eau<\/span>, tandis que celui d\u2019une femme en contient entre <\/span>45 et 60 %<\/span> dans un contexte de sant\u00e9 normale.<\/span><\/p>\n

L\u2019objectif m\u00e9dical principal est de r\u00e9duire la masse graisseuse visc\u00e9rale et abdominale plut\u00f4t que de se concentrer uniquement sur le poids. L\u2019augmentation de la masse musculaire permet d\u2019augmenter les d\u00e9penses \u00e9nerg\u00e9tiques de l\u2019organisme, de favoriser la fonte de la graisse visc\u00e9rale utilis\u00e9e comme carburant, de r\u00e9duire le tour de taille et d\u2019am\u00e9liorer la sant\u00e9 globale, m\u00eame lorsque le poids ne diminue pas de mani\u00e8re significative.<\/span><\/p>\n

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Conclusion : d\u00e9passer la logique du chiffre sur la balance<\/span><\/h2>\n

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La prise en charge de l\u2019ob\u00e9sit\u00e9 repose sur une approche globale qui d\u00e9passe largement la simple mesure du poids.<\/a> L\u2019int\u00e9gration de l\u2019IMC, du tour de taille, de la r\u00e9partition de la graisse, des comorbidit\u00e9s et de la sant\u00e9 mentale permet une compr\u00e9hension plus fine de la maladie et une am\u00e9lioration durable de la sant\u00e9 des personnes concern\u00e9es. De plus, des experts comme S\u00e9verine Mazur<\/a> peuvent vous pr\u00e9senter d’uniques solutions comme le allurion gastric balloon<\/a>.<\/span><\/p>\n

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The Allurion gastric balloon is much more than a slimming solution: it's a complete re-education of body and mind. In just 4 months, without surgery or anesthesia, patients lose up to 15 % of their body weight and regain balance, well-being and confidence.<\/p>","protected":false},"author":2,"featured_media":4062,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-4053","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-comprendre-obesite"],"yoast_head":"\nMesures utiles en m\u00e9decine de l\u2019ob\u00e9sit\u00e9 : au-del\u00e0 de l\u2019IMC<\/title>\n<meta name=\"description\" content=\"L\u2019IMC ne suffit pas pour diagnostiquer et suivre l\u2019ob\u00e9sit\u00e9. 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