The European Association for the Study of Obesity (EASO) has unveiled a new framework for diagnosing and managing obesity in adults. Published in Nature Medicine, this approach moves beyond the traditional Body Mass Index (BMI) cutoff, potentially expanding treatment options for many individuals previously excluded from obesity care.
Obesity, long recognized as a complex, chronic disease involving excessive body fat accumulation, has historically been diagnosed using BMI alone. However, this method fails to account for crucial factors like fat distribution, which significantly impacts health risks.
Beyond BMI: A More Comprehensive Approach
The EASO Steering Group, comprising leading obesity experts, has developed a series of statements to align obesity management with the latest scientific knowledge. Their framework emphasizes that BMI alone is insufficient for diagnosis.
“An important novelty of our framework regards the anthropometric component of the diagnosis. The basis for this change is the recognition that BMI alone is insufficient as a diagnostic criterion, and that body fat distribution has a substantial effect on health. More specifically, 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 (BMI of 30),” the authors state.
This new approach recognizes abdominal fat accumulation as a significant health risk, even in individuals with lower BMIs. It expands the definition of obesity to include people with BMIs between 25 and 30 who have increased abdominal fat and related health complications.
Expanding Treatment Options
While the core pillars of obesity treatment remain largely unchanged – including nutritional therapy, physical activity, and stress reduction – the new framework proposes broadening access to medications and surgical interventions.
The authors suggest considering obesity medications for patients with a BMI of 25 or higher, a waist-to-height ratio above 0.5, and the presence of obesity-related complications. This recommendation challenges current guidelines that often restrict these treatments based solely on BMI cutoffs.
“This statement may also be seen as a call to pharmacological companies and regulatory authorities to use inclusion criteria that are more adherent to the clinical staging of obesity and less to traditional BMI cut-offs when designing future clinical trials with obesity medications,” the authors explain.
The framework emphasizes long-term, personalized treatment plans over short-term weight loss goals. It aims to shift obesity management towards a more comprehensive approach, similar to other chronic diseases.
By moving beyond BMI as the sole diagnostic criterion, this new framework could significantly impact how obesity is diagnosed, treated, and researched in the coming years. It represents a step towards more personalized and effective obesity care, potentially benefiting millions of individuals worldwide.
