The Lancet launches new framework for redefining obesity as a chronic disease
The Lancet Commission on Clinical Obesity, composed of over 50 global health experts, has launched groundbreaking guidelines to redefine obesity as a chronic, systemic illness.
Published in The Lancet Diabetes & Endocrinology, the guidelines introduce a nuanced framework to diagnose and treat obesity, ensuring more accurate care and reducing the risk of over-diagnosis.
A new framework for understanding obesity
The guidelines propose distinguishing between two stages of obesity:
- Pre-clinical obesity: Excess body fat that does not yet cause organ dysfunction or health issues but poses a future risk.
- Clinical obesity: Excess body fat that has led to health complications such as high blood pressure, obesity-linked heart failure, sleep apnoea or hip or knee joint pain, requiring immediate medical intervention.
“Obesity is a spectrum,” explains Prof Francesco Rubino, Chair of the report and a leading expert at King’s College London.“Some individuals manage to live healthy lives with excess body fat, while others experience severe health challenges. This new framework allows us to better assess and address the needs of each patient.”
Moving beyond BMI
The guidelines call for a shift away from the reliance on Body Mass Index (BMI) as the sole diagnostic tool for obesity. Instead, they recommend using a combination of measures, such as high bmi combined with waist-to-height ratio or direct fat measurements
Subsequent medical history, physical examination and investigations then help determine if there are health problems due to the high body fat - what is now termed clinical obesity - or associated health problems as yet (now termed preclinical obesity).
These tools provide a more comprehensive understanding of a patient’s health and ensure that treatment is tailored to individual needs.
READ THE STUDY
_800_800_s_c1.jpg)
Addressing the global obesity crisis
With over 1 billion people currently living with obesity worldwide and numbers projected to rise to 1.5 billion by 2035, these guidelines come at a critical time. They aim to:
- Improve the accuracy of clinical obesity diagnoses.
- Reduce unnecessary treatments.
- Ensure equitable, evidence-based care.
The guidelines also highlight the urgency of addressing obesity’s role in driving non-communicable diseases (NCDs) such as heart disease, diabetes, and certain cancers. By focusing on early intervention and accurate diagnosis, healthcare systems can better allocate resources and prioritise care for those most in need.
READ THE STUDY
A call for person-centred care
Stigma and misdiagnosis remain significant barriers to effective obesity care. These guidelines emphasise the importance of:
- Providing inclusive, person-centred care free from stigma.
- Offering appropriate prevention, counselling, and treatment tailored to each stage of obesity.
- Training health professionals to better understand and address the complexities of obesity.
Children’s obesity expert Prof Louise Baur, who contributed to the report, states, “This approach will help adults and children receive the right care at the right time while reducing unnecessary interventions.”
READ THE STUDY
A turning point in obesity care
The launch of these guidelines represents a significant step forward in addressing the global obesity crisis. They provide a clear pathway for healthcare systems to integrate obesity into their frameworks, ensuring that it is treated with the same medical rigour and compassion as other chronic illnesses.
The World Obesity Federation calls on policymakers, healthcare providers, and global leaders to adopt these recommendations and work towards a world where every person has access to the care they need.
Read the new framework
To learn more about the new guidelines and how they aim to reshape obesity care, visit the link below.
READ MORE