A new study led by a global panel of medical experts, including Professor Lim Soo from the Division of Endocrinology and Metabolism at Seoul National University Bundang Hospital (SNUBH), has redefined obesity as a chronic disease rather than simply excess weight. This groundbreaking shift in the understanding of obesity is expected to influence treatment strategies and public health policies on a global scale.
The study, conducted by the Lancet Diabetes & Endocrinology Commission, includes input from 58 multidisciplinary experts worldwide. The commission stresses the importance of recognizing obesity as a condition that impacts organ and tissue function, not just a measure of body mass index (BMI). This new framework for diagnosis challenges the traditional view of obesity as merely a risk factor for diseases like diabetes and cardiovascular conditions.
Obesity has now been classified as a “chronic, systemic disease characterized by abnormal impairment of organ function due to excessive body fat.” According to the commission, obesity can directly damage organs and tissues, potentially leading to severe health complications such as heart attacks, strokes, and heart failure.
The commission has proposed two categories to help identify and address obesity: clinical obesity and preclinical obesity. Clinical obesity refers to a state where excess fat causes significant health problems, while preclinical obesity is characterized by a higher risk of developing obesity-related diseases despite normal organ function at present. This distinction allows for more effective treatment and public health interventions.
The study also calls attention to the limitations of BMI as a sole measure of health. While BMI is useful for population-level assessments, it fails to consider the distribution of fat or functional impairments caused by excess body fat. The commission recommends combining BMI with other assessment tools such as body fat measurements, waist circumference, and waist-to-hip ratios to provide a more accurate health profile.
In cases where BMI exceeds 40 kg/m², the commission acknowledges that excessive fat accumulation is apparent and further assessments may be unnecessary. However, to diagnose clinical obesity, the commission outlines clear criteria, including evidence of impaired organ function or significant limitations in daily activities like bathing, dressing, and mobility.
One of the study’s major conclusions is that obesity is not merely a result of lifestyle choices but is influenced by genetic, hormonal, and environmental factors. The commission also notes that weight-based stigma and discrimination remain significant barriers to effective prevention and treatment of obesity.
Given the strong likelihood of obesity leading to severe health complications, the study advocates for early medical intervention. In addition to lifestyle changes, pharmacological treatments and surgical options should be considered, especially for individuals in the preclinical obesity category.
The commission’s findings have garnered widespread support from 75 medical societies and patient organizations globally, marking a pivotal step toward a new approach to obesity management.
Professor Lim Soo, a key contributor to the study, emphasized the importance of combating obesity stigma. “Blaming individuals for obesity hinders effective prevention and treatment,” he said. “It is essential to develop public health strategies based on scientific evidence.”
This new diagnostic framework aims to shift global perspectives on obesity and guide more targeted, evidence-based health policies.
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