News: New disease definition ‘clinical obesity’ to be published in January 2025
Last week at the Obesity Society’s Obesity Week meeting, a preview was shown of an upcoming document to reframe the diagnosis of obesity, Medscape Medical News reported. Authors of the new framework, set to be published in mid-January 2025, include 56 of the world’s leading obesity experts, including academic clinicians, scientists, public health experts, patient representatives, and officers from the World Health Organization. The document will be published in The Lancet Diabetes & Endocrinology after peer review, and has been formally endorsed by more than 75 medical societies and other relevant stakeholder organizations.
The document will entirely reframe obesity as a “condition of excess adiposity” that constitutes a disease called “clinical obesity” when related tissue and organ abnormalities are present. During the preview, the publication’s lead author Francesco Rubino, MD, chair of bariatric and metabolic surgery at King’s College London, United Kingdom, noted the concept of obesity as a chronic disease is still debated and not widely accepted by either the public or the medical community despite the American Medical Association declaring it so in 2013. Part of this controversy is contributed to by the current body mass index (BMI)-based definition having no distinction between people at risk of disease because of excess adiposity versus those who’ve already experienced bodily harm because of it.
“Having a framework that distinguishes at an individual level when you are in a condition of risk and when you have a condition of disease is fundamentally important. You don’t want to blur the picture in either direction, because obviously the consequence would be quite significant. […] So, the commission focused exactly on that point,” said Rubino.
The new paper will propose a two-part clinical approach:
- Assess if the patient has excess adiposity or not
- Assess on an organ-by-organ basis for abnormalities related to it
The methods for assessment and specific criteria will be provided in the document, and BMI will only be a preliminary screening tool before additional measures are used to establish if the obesity is clinical or nonclinical.
“Policymakers scratch their heads when they have limited resources and you need to prioritize things. Having an obesity definition that is blurry doesn't allow you to have a fair, human, and meaningful prioritization,” Rubino told Medscape Medical News. “Now that we have drugs that cannot be given to 100% of people, how do you decide who gets them first? I hope this will make it easier for people to access treatment.”
Editor’s note: To read Medscape Medical News’ coverage of this story, click here.