The European Association for the Study of Obesity (EASO) has introduced a new framework for the diagnosis, staging and management of obesity in adults. Published in Nature, this initiative aims to better reflect obesity as an adiposity-based chronic disease rather than relying solely on body mass index (BMI) cut-off values. The traditional method does not adequately consider the distribution and function of adipose tissue, which plays a significant role in the severity of the disease. This new approach contrasts with the management of other chronic diseases, which involve clear therapeutic indications, set targets, and tailored treatment intensification. To align obesity management with these standards, EASO conducted a consensus process involving many key opinion leaders in the field of obesity resulting in 28 consensus statements across four themes: clinical diagnosis and staging, pillars of treatment, therapeutic targets and initial level of intervention.
Some of the key statements include:
- Abdominal (visceral) fat accumulation is an important risk factor for health deterioration, even in people with low BMI and free of overt clinical manifestations (statement 3).
- Include people with lower BMI (≥25–30 kg/m²) but with increased abdominal fat accumulation and any medical, functional, or psychological impairments in the definition of obesity (statement 4).
- Functional and psychological evaluations should use a range of methods, from easy tests in primary care to sophisticated tests in specialized centres (statements 10 and 13).
- For older individuals with obesity, diagnostic assessment should include muscle strength, performance, and body composition evaluations for sarcopenic obesity (statement 11).
- Regular screening for obesity-related cancers should be conducted in any person with obesity (statement 12).
- Obesity should be staged as a chronic, relapsing disease according to the severity of its clinical manifestations and complications (statement 14).
- Behavioural modifications, including nutritional therapy, physical activity, stress reduction, and sleep improvement, are main cornerstones of obesity management (statement 16).
- Obesity medications should be considered for patients with a BMI ≥25 kg/m² and a waist-to-height ratio >0.5 with medical, functional, or psychological impairments or complications, independent of traditional BMI cut-offs (statement 18).
- Obesity management should move beyond weight loss alone to include prevention, resolution, or improvement of obesity-related complications, better quality of life and mental well-being, and improved physical and social functioning and fitness (statement 22).
- Long-term personalized therapeutic goals should be defined, considering the disease stage and severity, available therapeutic options, potential side effects and risks, patient preferences, individual drivers of obesity and possible barriers to treatment (statement 23 and 24).
- Emphasis should be placed on the need for a long-term or lifelong comprehensive treatment plan rather than short-term body weight reduction (statement 25).
Commenting on the recommendations, Professor Gijs Goossens (Maastricht University Medical Center) said, “We anticipate that, in conjunction with other ongoing initiatives, the recommendations outlined in this paper will contribute to improving obesity management and quality of life in adults living with obesity”.
Disclosures: This article was created by the touchENDOCRINOLOGY team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
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