A Defining Moment: A Consensus on the Diagnostic Criteria for Clinical Obesity

Le résumé fourni par la source

Obesity is widely recognized as a body mass index (BMI) ≥30 kg/m2 in adults where excess adiposity leads to an increased risk of impaired health (1). According to the WHO, in 2022, approximately 890 million adults were obese (2). However, the tendency for BMI to over- or underestimate adiposity has been well established, with several studies proposing other anthropometric measurements (such as waist circumference); each of these alternatives has its own potential limitations (3). Despite past attempts to classify obesity as a disease in and of itself, the concept remains controversial. A recent article details the findings of a Lancet Commission, which sought to establish an objective set of criteria to define clinical obesity (4). After extensive meetings by experts in the field, the Commission reached unanimous or near unanimous agreement on all 37 consensus statements put forth for discussion. Included among these statements, the Commission agreed to reframe obesity as the presence of excess adiposity that may directly cause disease, which they termed clinical obesity; a chronic, systemic illness with identifiable abnormalities in either tissue function or organ function, or the presence of general dysfunction in an individual as a direct cause of excess adiposity. This new definition deviates from the current dogma that obesity is simply excess adiposity (primarily based on BMI) leading to an increased risk of adverse health. Along with newly proposed terms, the Commission introduced a working model for the objective diagnosis of clinical obesity that includes both anthropometric and clinical parameters to determine the obesity status of an individual.

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