Two groups are proposing a new definition of obesity that considers factors beyond body mass index.
The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) are calling for obesity to be defined by obesity-related complications along with body mass index. The new definition – which includes five different categories – will allow physicians to better target treatments based on individual needs, experts said.
“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….What we’re doing is rebooting the system, essentially,” said AACE president Dr. Jeffrey I. Mechanick, clinical professor of medicine at Mt. Sinai School of Medicine, New York, at a press conference.
The proposal comes after the American Medical Association’s 2013 designation of obesity as a chronic disease. The concept of redefining the disease came from brainstorming sessions held as part of a conference earlier this year.
The five new proposed categories include:
1. Normal weight (BMI of less than 25).
2. Overweight (BMI of 25 to 29.9, no obesity-related complications).
3. Obesity stage 0 (BMI of 30 or greater and no obesity-related complications).
4. Obesity stage 1 (BMI of 25 or greater with the presence of one or more mild to moderate obesity-related complications).
5. Obesity stage 2 (BMI of 25 or greater and the presence of one or more severe obesity-related complications). Obesity-related complications include the following metabolic syndrome, prediabetes, type 2 diabetes, dyslipidemia, hypertension, nonalcoholic fatty liver disease, polycystic ovary syndrome, sleep apnea, osteoarthritis, gastroesophageal reflux disease and disability/immobility.
“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,” said W. Timothy Garvey, chair of the AACE/ACE Consensus Conference on Obesity and Obesity Scientific Committee and author of the proposed definition.
The United States is the 10th most obese nation in the world, with 30 percent of the population classified as obese. That figure has doubled since 1980, increasing the risk of myriad diseases including type 2 diabetes.