New European Obesity Framework Reclassifies Millions as Obese
European criteria expand obesity definition beyond BMI, affecting nearly one-fifth of overweight individuals.
The new diagnostic framework from the European Association for the Study of Obesity (EASO) redefines obesity by including additional factors beyond BMI, resulting in nearly 19% of previously overweight individuals being newly classified as obese.
Study Details:
The recent EASO framework, published in the Annals of Internal Medicine, advocates a more comprehensive approach to diagnosing obesity. Unlike the traditional Body Mass Index (BMI)-only method, the EASO criteria also factor in waist-to-hip ratio (WHtR) and associated medical, functional, or psychological complications such as hypertension, diabetes, arthritis, cardiovascular diseases, renal conditions, COPD, and depression.
Methodology:
Researchers analyzed data from 44,030 adults participating in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, examining BMI, WHtR, and various health complications. They assessed mortality risks among groups defined by traditional BMI categories versus the new EASO criteria.
Key Findings:
The EASO framework identified an additional 18.8% of U.S. adults as obese, raising the total prevalence to 54.2%.
Among those newly classified as obese, hypertension was the most common complication (79.9%), followed by arthritis (33.2%), diabetes (15.6%), and cardiovascular disease (10.5%).
Individuals newly defined as obese under EASO did not have an elevated overall mortality risk compared to normal-weight individuals without adjusting for comorbidities. However, when compared directly with healthy normal-weight individuals, their mortality risk increased by 50%.
Implications for Practice:
This shift in classification underscores the importance of adopting a more holistic view in obesity management.
For patients, this reclassification may lead to earlier intervention and improved health outcomes.
For healthcare providers, the new framework facilitates a more nuanced understanding of obesity-related risks, enhancing preventive strategies and potentially influencing policy decisions around obesity management and treatment coverage.