A new framework for the diagnosis, staging and management of obesity in adults: Publication comment from Professor Gijs Goossens

A new framework for the diagnosis, staging and management of obesity in adults: Publication comment from Professor Gijs Goossens

The European Association for the Study of Obesity (EASO) has presented a new framework for the diagnosis, staging and management of obesity in adults to better align with the concept of obesity as an adiposity-based chronic disease. This new framework, published in Nature Medicine, is based on the outcomes of a modified Delphi study that was conducted by EASO, involving many key opinion leaders in the field of obesity. The results of this study, which was led by Dr. Luca Busetto (University of Padova, Italy) and Prof. Gijs Goossens (Maastricht University, the Netherlands), were published in Nature Medicine today. https://doi.org/10.1038/s41591-024-03095-3 https://www.nature.com/articles/s41591-024-03095-3

Obesity is a multifactorial, chronic, relapsing, non-communicable disease marked by an abnormal and/or excessive accumulation of body fat that presents a risk to health. It is well established that obesity acts as a gateway to a range of other non-communicable and communicable diseases. Despite this wide recognition of obesity as a chronic disease, the clinical recommendations that guide the diagnosis of obesity and its management have not been aligned sufficiently with the clinical processes normally adopted for other chronic diseases. In many settings, the diagnosis of obesity is still based solely on body mass index (BMI) cut-off values, and does not reflect the role of adipose tissue distribution and function in the severity of the disease. The accumulation of abdominal fat is associated with an increased risk of developing cardiometabolic complications and is a stronger determinant of disease development than BMI, even in individuals with a BMI level below the standard cut-off values for obesity diagnosis. The latter is emphasized in this new framework, since it important to reduce the risk of undertreatment in the latter group of patients, according to the authors of the paper. Moreover, the indications for using the different therapeutic approaches now available for obesity management also remain mostly based on anthropometric measurements, rather than on a more complete clinical evaluation of the patient, taking into account medical, functional, and psychological impairments. This is in sharp contrast with other chronic diseases, for which clear therapeutic indications are described, targets are set, and the choice of the type and intensity of treatment is based on the probability to reach the treatment target, with adequate and prompt treatment intensification when the target is not reached.

“We anticipate that, in conjunction with other ongoing initiatives, the recommendations outlined in this paper will contribute to improving obesity management and quality of life in adults living with obesity”, said Professor Gijs Goossens.

Download the final paper (PDF)

DOI 10.1038/s41591-024-03095-3.

OTHER ARTICLES OF INTEREST