SNUBH professor participates in study to redefine obesity as a chronic disease < Hospital < Article

A global panel of medical experts, including Professor Lim Soo from the Division of Endocrinology and Metabolism at Seoul National University Bundang Hospital, has introduced a new diagnostic framework for obesity, recognizing it as a chronic disease rather than simply excess weight.

The Lancet Diabetes & Endocrinology Commission, comprised of 58 multidisciplinary experts from various countries, has emphasized the need for a comprehensive diagnostic approach that considers the impact of obesity on organ and tissue function rather than solely relying on body mass index (BMI).

The paradigm shift is expected to reshape obesity treatment and public health policies worldwide.

Traditionally, obesity has been perceived merely as an issue of excess weight or as a risk factor for other conditions such as diabetes and cardiovascular disease.

However, the commission has redefined obesity as a “chronic, systemic disease characterized by abnormal impairment of organ function due to excessive body fat.”

The panel warned that obesity itself can cause significant organ and tissue damage, leading to life-threatening complications such as heart attack, stroke, and heart failure.

To better categorize the condition, the commission proposed two distinct classifications — ㅊlinical obesity and preclinical obesity.

Clinical obesity refers to a state in which excessive body fat directly causes severe health complications, while preclinical obesity denotes an increased risk of developing obesity-related diseases despite normal organ function at present.

The distinction aims to guide treatment strategies and public health interventions more effectively.

The panel highlighted the limitations of BMI as an accurate measure of an individual’s health. While BMI remains a useful tool for population-level assessments, it does not reflect fat distribution or functional impairments caused by excess body fat.

Consequently, BMI-based diagnosis may misclassify healthy individuals as obese or overlook those at significant health risk.

To address these shortcomings, the commission recommended using additional assessment tools alongside BMI, such as direct body fat measurements, waist circumference, waist-to-hip ratio, and waist-to-height ratio.

However, they noted that in cases where BMI exceeds 40 kg/m², excessive fat accumulation is evident, and further assessments may not be necessary.

The commission outlined clear criteria for diagnosing clinical obesity. Evidence of impaired organ function due to obesity or limitations in physical activity or essential daily activities such as bathing, dressing, toileting, independent mobility, or eating qualifies a patient for a clinical obesity diagnosis, reinforcing the idea that obesity is a medical condition requiring targeted intervention.

One of the most significant takeaways from the study is the recognition of obesity as a disease that extends beyond lifestyle choices.

The commission stressed that obesity results from a complex interplay of genetic, hormonal, and environmental factors. Also, weight-based discrimination and stigma have been identified as major barriers to effective prevention and treatment.

Given the high likelihood of obesity progressing into severe health complications, early and proactive medical intervention is crucial.

Beyond lifestyle modifications, the panel urged consideration of pharmacological treatments and surgical options where necessary.

Individuals in the preclinical obesity category should receive continuous health monitoring and counseling to mitigate disease progression.

The commission’s findings received widespread support from 75 medical societies and patient organizations worldwide, marking a pivotal step toward redefining obesity and its management.

Professor Lim emphasized the importance of combating obesity stigma and shifting towards scientifically grounded public health policies.

“Blaming individuals for obesity hinders effective prevention and treatment. It is essential to develop public health strategies based on scientific evidence,” he said.