Professor Luca Busetto responds to the new EASO publication in Nature Medicine: A new framework for the diagnosis, staging and management of obesity in adults

Professor Luca Busetto responds to the new EASO publication in Nature Medicine: A new framework for the diagnosis, staging and management of obesity in adults

Despite this wide recognition of obesity as a chronic disease, the clinical recommendations guiding the diagnosis of obesity and its management are not yet aligned sufficiently with the clinical processes normally adopted for other chronic diseases. In many settings, diagnosis of obesity remains simply based on Body Mass Index (BMI) cut-offs, not reflecting the role of adipose tissue distribution
and function on the severity of the disease. Moreover, a diagnosis simply based on anthropometric measurements does not take into account the impact that an abnormal and/or excessive accumulation of body fat may have on medical, functional and psychological health. The stage of disease progression is frequently not included in the clinical assessment.

The indications for using the therapeutic approaches now available for obesity management also remain primarily centered around anthropometric measurements, and not on a more comprehensive clinical evaluation of the patient. Obesity guidelines usually present the particular strategies and approaches that can be used across particular BMI classes, but do not guide the health care professional in selection of the treatment modality that is appropriately indicated based on clinical severity of the disease. This old framework could promote therapeutic inertia, leading to potential progression of obesity disease.

In order to inspire change in the way obesity is diagnosed and managed among clinicians and understood by relevant stakeholders, EASO has developed this commentary, proposing a new framework for the diagnosis, staging and management of obesity in adults. “We believe that this work, in conjunction with similar initiatives, can help to move obesity management in a direction more aligned with the concept of obesity as a chronic disease,” writes lead author Luca Busetto.

Read the full comment from authors Luca Busetto, Dror Dicker, Gema Frühbeck, Jason C. G. Halford, Paolo Sbraccia, Volkan Yumuk & Gijs H. Goossens in Nature Medicine: https://www.nature.com/articles/s41591-024-03095-3

Download the final paper (PDF)

DOI 10.1038/s41591-024-03095-3.

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