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An expert panel recently sought to establish objective criteria for diagnosing and treating obesity, aiming to support clinicians and guide public health strategies. The group comprised 58 experts across several specialties and countries, including people with lived experience of obesity.

“The specific aim of the Commission was to establish objective criteria for disease diagnosis, aiding clinical decision making and prioritization of therapeutic interventions and public health strategies,” wrote W. Timothy Garvey, MD, and colleagues.

Regarding clinical evaluations, the experts listed the following recommendations:

› BMI should be used only for measuring health risk at the population level, conducting epidemiological studies, or screening. It should not be used as an individual measure of health.

› To confirm excess adiposity, clinicians should directly measure body fat or evaluate patients for at least one anthropometric criterion in addition to BMI. These criteria may include waist circumference, waist-to-hip ratio, or waist-to-height ratio.

› Excess adiposity can be assumed in patients with very high BMI (>40 kg/m2 ) without additional confirmation.

› People with confirmed obesity status should be assessed for clinical obesity. To meet diagnostic criteria for clinical obesity, patients must have one or both of the following:

› Evidence of reduced organ or tissue function due to obesity

› Substantial, age-adjusted limitations of daily activities reflecting the specific effect of obesity on mobility, other basic activities of daily living

The article included the following guidance for management:

› Clinical Obesity: Patients should receive timely, evidence-based treatment to improve or resolve clinical manifestations of obesity and prevent severe organ damage.

› Preclinical Obesity: Patients should receive health counseling, and clinicians should monitor health status longitudinally. When appropriate, clinicians should intervene to reduce the risk for clinical obesity and related diseases.

› Healthcare professionals and policymakers should receive training to reduce weight-based bias and stigma, which can interfere with efforts to prevent and treat obesity