Liverpool Professor contributes to global report on obesity
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A University of Liverpool researcher and Honorary Consultant in Diabetes and Endocrinology at Aintree University Hospital, has played a key role in a crucial new report on obesity.
Professor John Wilding, who leads clinical research into obesity contributed his insights to the report which introduces two new categories of obesity – clinical obesity and pre-clinical obesity.
More than one billion people in the world live with obesity however current measures that are based on body mass index (BMI) do not allow accurate disease diagnosis, hindering care and policy.
The Lancet Diabetes & Endocrinology: Global Commission proposes major overhaul of obesity diagnosis, going beyond BMI to define when obesity is a disease. The Commission on Clinical Obesity recommends a new approach where measures of body support making a clinical diagnosis of obesity and introduces two new diagnostic categories: ‘clinical obesity’, a chronic disease with specific signs and symptoms of ongoing organs’ dysfunction due to obesity alone; and ‘pre-clinical obesity’, when excess adiposity is associated with variable level of health risk, but no ongoing illness.
In the report, commissioned by The Lancet Diabetes & Endocrinology, Professor Wilding joined 56 world leading experts. He made a major contribution to the section of the report that describes the causes and associated complications of obesity.
Professor John Wilding said: “There is an urgent need for health systems globally to adopt a universal, clinically relevant definition of obesity. This reframing identifies medically meaningful targets for prevention and treatment of obesity and facilitates a more rational and fairer allocation of healthcare resources and a reduction in the stigma associated with a diagnosis of obesity.”
More about The Lancet Diabetes & Endocrinology: Global Commission
The commission is endorsed by more than 75 medical organisations around the world and presents a novel, nuanced approach to diagnose obesity, based on other measures of excess body fat in addition to body mass index (BMI), and objective signs and symptoms of ill health at the individual level.
The proposal is designed to address limitations in the traditional definition and diagnosis of obesity that hinder clinical practice and healthcare policies, resulting in individuals with obesity not receiving the care they need. By providing a medically coherent framework for disease diagnosis, the Commission also aims to settle the ongoing dispute around the idea of obesity as a disease, which has been at the centre of one of most controversial and polarising debates in modern medicine.
Commission chair, Professor Francesco Rubino, King's College London said: “The question of whether obesity is a disease is flawed because it presumes an implausible all-or-nothing scenario where obesity is either always a disease or never a disease. Evidence, however, shows a more nuanced reality. Some individuals with obesity can maintain normal organs’ function and overall health, even long term, whereas others display signs and symptoms of severe illness here and now.
“Considering obesity only as a risk factor, and never a disease, can unfairly deny access to time-sensitive care among people who are experiencing ill health due to obesity alone. On the other hand, a blanket definition of obesity as a disease can result in overdiagnosis and unwarranted use of medications and surgical procedures, with potential harm to the individual and staggering costs for society.
“Our reframing acknowledges the nuanced reality of obesity and allows for personalised care. This includes timely access to evidence-based treatments for individuals with clinical obesity, as appropriate for people suffering from a chronic disease, as well as risk-reduction management strategies for those with pre-clinical obesity, who have an increased health risk, but no ongoing illness. This will facilitate a rational allocation of healthcare resources and a fair and medically meaningful prioritisation of available treatment options.”
The Commission involved 56 experts across a broad range of medical specialties, including endocrinology, internal medicine, surgery, biology, nutrition and public health, representing many countries and diverse healthcare systems. The Commission also included people living with obesity and specifically considered the potential impact of the new definitions of obesity on widespread societal stigma.
Read the full report here.