Recent improvements in GLP-1 medications, such as the arrival of oral versions of Wegovy in the UK and Australia, have made it easier for people to lose a significant amount of weight. However, these medical advances have revealed a major problem: there is no globally accepted clinical definition of obesity.

近期 GLP-1 藥物的進步，例如 Wegovy 口服版本的在英國與澳洲上市，讓人們更容易減掉大量體重。然而，這些醫療進展也揭露了一個重大問題：全球缺乏一個公認的肥胖臨床定義。

In the past, the way doctors viewed obesity changed from a general health perspective to a risk-based model created by the insurance industry. This change replaced detailed medical exams with the Body Mass Index (BMI), which was designed for studying large groups of people rather than diagnosing individuals. Consequently, many patients only received treatment if they already had other health problems, meaning those whose main issue was simply excess weight were often ignored.

過去，醫生看待肥胖的角度從一般的健康視角，轉變為由保險業建立的風險模型。這種改變以身體質量指數 (BMI) 取代了詳細的醫療檢查，而 BMI 的設計初衷是用於研究大群體而非診斷個人。因此，許多患者直到出現其他健康問題後才獲得治療，這意味著那些主要問題僅為體重過重的人往往被忽略了。

Currently, there is a debate over whether obesity should be seen as a chronic disease for everyone or as a risk factor. If it is treated as a universal disease, more people can get help; however, this might lead to over-treating people who have no symptoms. On the other hand, treating it only as a risk factor might mean that people with serious organ damage do not get the care they need.

目前，關於肥胖應被視為所有人的慢性疾病還是風險因素，仍存在爭論。如果將其視為普遍疾病，更多人能獲得幫助；然而，這可能會導致沒有症狀的人被過度治療。另一方面，若僅將其視為風險因素，可能意味著器官受損嚴重的患者無法獲得所需的照顧。

To solve this problem, a Lancet commission has suggested a new system. They propose dividing the condition into 'clinical obesity,' where the patient has clear organ damage, and 'pre-clinical obesity,' where the organs function well but the risk is high. This approach aims to make obesity treatment similar to heart disease or cancer care, ensuring that the strength of the medication or surgery matches the patient's actual physical needs.

為了p解決這個問題，《柳葉刀》(Lancet) 委員會建議了一套新系統。他們提議將此情況分為「臨床肥胖」（患者有明顯器官損壞）以及「臨床前肥胖」（器官功能良好但風險較高）。此方法旨在使肥胖治療與心臟病或癌症治療相似，確保藥物強度或手術方案符合患者實際的身體需求。

The medical community is now considering a move away from relying solely on BMI. Instead, they are looking at a two-category model to make treatments more effective and affordable for healthcare systems.

醫學界目前正考慮不再單純依賴 BMI。相反地，他們正在研究一種雙類別模型，以使治療對醫療體系而言更有效且更經濟實惠。