Doctors with the American Association of Clinical Endocrinologists and the American College of Endocrinology have proposed a new definition of obesity that takes into account Body Mass Index and weight-related complications.
AACE President Dr. Jeffery Mechanick said the old definition isn’t precise enough.
“Regarding obesity as simply a number reflecting BMI to then dictate the way you manage it may be a good reason why, after so many years, the prevalence rates of overweight and obesity haven’t changed much,” said Mechanick. “What we’re doing is rebooting the system, essentially.”
The move to redefine obesity comes less than a year after the American Medical Association reclassified obesity as a chronic disease. Doctors believe the new method will give patients a better understanding of how obesity has impacted their health.
“We’re using weight-loss therapy to treat the complications of obesity in a medical model that’s really designed to treat disease,” said Dr. W. Timother Garvey. “It’s not so much the additional BMI that’s of primary importance, it’s the degree to which that weight gain has impacted the health of the individual in terms of the presence and severity of obesity-related complications.”
5 Category Approach
The old definition of obesity simply looked at a person’s BMI. A person with a BMI of 24 or less was considered at a normal weight, while anyone with a BMI of 25 or higher was considered overweight. The new definition classifies obesity into one of five categories:
1. Normal weight (BMI < 25).
2. Overweight (BMI 25–29.9, no obesity-related complications).
3. Obesity stage 0 (BMI 30 or greater and no obesity-related complications).
4. Obesity stage 1 (BMI 25 or greater and the presence of 1 or more mild to moderate obesity-related complications).
5. Obesity stage 2 (BMI 25 or greater and the presence of 1 or more severe obesity-related complications).
Medical professionals also listed some of the most common obesity related complications, including: prediabetes; type 2 diabetes; metabolic syndrome; nonalcoholic fatty liver disease; polycystic ovary syndrome; sleep apnea; dyslipidemia; hypertension; osteoarthritis; gastroesophageal reflux disease; and disability/immobility.
Lifestyle Modifications
AACE members came up with lifestyle modification guidelines for any person classified as obesity stage o and above. The recommendations include:
Obesity Stage 0: Activity and diet modification.
Obesity Stage 1: Intensive lifestyle modification and behavior therapy, with or without medications.
Obesity Stage 2: Intensive lifestyle modification/behavior therapy and medications, with consideration for bariatric surgery.
Dr. Mechanick concluded by saying he hopes the new definition spurs action from the government and from citizens.
“Our hope is that we can actually make a difference….Maybe the [American Medical Association] will buy into it, maybe Congress will buy into it with more antiobesity legislative acts. Once you get a critical mass with all this action, then a complex disease is managed in a complex fashion and you see a difference. We believe that obesity is a complex disease and is not effectively managed with simple solutions.”
Dr. Silverman comments
I think it is a good move to keep a closer eye on the complications caused by obesity. The old BMI model wasn’t perfect, and the new model gives it a more individualized feel as opposed to a one-size-doesn’t-fit-all model.
Defining the problem is the first step. Now doctors and patients need to work together to fight the problem. Learning more about the issue does no good if you don’t do anything to correct it.
Related source: Medscape
