A global Commission presents a new approach to diagnose obesity
The Commission, led by Professor Francesco Rubino, King's College London (UK), involving Sadaf Farooqi from IMS (Steering Group) and over 60 experts in obesity from around the world, addressed the longstanding debate among clinicians, scientists and policymakers over the concept of obesity as a disease.
Currently, obesity is defined by as a body mass index (BMI) over 30 kg/m2 with country-specific cutoffs to account for ethnic variability of obesity-related risk. BMI is easy to measure (weight in kg/height in metres squared) and useful for following trends at a population level but is not a direct measure of fat, does not reflect its distribution around the body and does not provide information about health and illness at the individual level.
The Commission on Clinical Obesity recommends a new, nuanced approach where measures of body fat - for example, waist circumference or direct fat measurement - in addition to BMI are used to detect obesity.
Additionally, the authors introduce two new diagnostic categories of obesity; ‘clinical obesity’ (a chronic disease associated with ongoing organ dysfunction due to obesity alone) and ‘pre-clinical obesity’ (associated with a variable level of health risk, but no ongoing illness).
This report, which takes into account a substantial amount of scientific evidence about the biology of obesity and its complications. It addresses limitations in the definition and diagnosis of obesity that hinder clinical practice and healthcare policies, resulting in individuals with obesity not receiving the care they need.
The Commission authors call for all people living with obesity to receive personalised health advice and evidence-based care when needed - free of stigma and blame - with different strategies for clinical obesity and pre-clinical obesity.
Sadaf Farooqi who co-authored the report commented: “This timely report leverages major advances in our scientific understanding of the causes and consequences of obesity to advocate for a change in health care policy. By considering obesity only as a risk factor, and never a disease, we deny people living with obesity access to time-sensitive care. This report seeks to change that by acknowledging the nuanced reality of obesity and the need for personalised assessment and care. This includes timely access to evidence-based treatments for individuals with clinical obesity, as appropriate for people suffering from any chronic disease, as well as risk-reduction management strategies for those with pre-clinical obesity, who have an increased health risk, but no ongoing illness.”
Further details about the report of the Commission and associated infographics can be found here.