0
0
São Paulo, June 29, 2024 — In a groundbreaking effort to reshape the understanding and treatment of obesity, The Lancet Commission on the Definition and Diagnosis of Clinical Obesity announced a comprehensive global study at the International Congress on Obesity. The congress, held in São Paulo from June 26 to 29, gathered experts to address the critical need for a clearer definition of obesity, a condition affecting over 1 billion people worldwide.
Despite its prevalence, obesity remains poorly defined, which hampers accurate diagnoses and effective treatments, while perpetuating stigma and prejudice. Specialists argue that obesity should be recognized as a chronic disease, not merely a condition leading to other diseases.
“The current definition of obesity is too broad and ineffective for our needs,” said Ricardo Cohen, MD, PhD, coordinator of the Obesity and Diabetes Specialized Center at the Oswaldo Cruz German Hospital in São Paulo and a key researcher in the study. He highlighted the numerous challenges arising from this imprecise definition, including confusion between prevention and treatment strategies, inadequate access to evidence-based treatments, and widespread misconceptions about obesity’s nature and reversibility.
Cohen emphasized the societal comfort with blaming individuals for their obesity, which supports the popularity of “magic solutions” like fad diets and the oversimplified view that obesity results solely from overeating and under-exercising. This perception, he noted, causes significant mental health damage.
One major issue is the classification of obesity as a risk factor rather than a disease. Cohen explained that obesity meets the criteria to be considered a disease, similar to diabetes and depressive disorders, with well-defined pathophysiologic and etiologic mechanisms. However, societal and healthcare sector perceptions lag, contributing to confusion and stigma.
This misunderstanding often leads to treatments focusing on preventing secondary diseases, such as diabetes and hypertension, rather than addressing obesity itself. Cohen shared a case of a patient suffering from fatigue, knee pain, and osteolysis who was denied appropriate care. “If he had diabetes, he could have access to treatment because diabetes is recognized as a disease and needs to be treated. But since obesity is not recognized as such, he was sent home,” Cohen recounted.
The Lancet Commission’s study aims to establish clear diagnostic criteria for both adults and children, drawing inspiration from medical disciplines with well-defined criteria, such as rheumatology and psychiatry. The study has identified 18 criteria for adults and 14 for children, redefining treatment outcomes and setting standards for the clinical remission of obesity.
Moreover, the study proposes clear recommendations for clinical practice and public health policies. The ultimate goal is to transform the global treatment spectrum of obesity and improve access to necessary care. “Our plan is to recognize obesity as a disease so that health policies, societal attitudes, and treatments will address it more effectively. This approach will also help reduce the harm caused by stigma and prejudice,” Cohen concluded.
The results of this pivotal study are expected to be published later this year, potentially marking a significant shift in how obesity is understood and managed worldwide.
