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Divergent obesity classification between the edmonton obesity staging system and the lancet commission model.
Obesity 34, 1989–1998 (2026)
OBJECTIVE: BMI alone does not capture obesity-related health heterogeneity. The Edmonton Obesity Staging System (EOSS) grades obesity severity based on comorbidities and functional impairment, whereas the Lancet Commission Diagnostic Model for Obesity (DMO) distinguishes preclinical from clinical obesity based on organ dysfunction. We compared classification patterns and concordance across both obesity frameworks in a large population-based cohort. METHODS: A modified EOSS and DMO were applied to the UK Biobank (N ≈ 411,000). Stage distributions, cross-classification, and the impact of combining BMI with fat distribution on obesity categorization were analyzed. RESULTS: About one-quarter of participants were classified with obesity under both frameworks. Most were assigned to advanced stages, with high concordance for established disease. Differences were most pronounced in early stages: DMO captured a broader spectrum of mild/subclinical organ dysfunction, whereas EOSS emphasized more advanced manifestations of obesity-related disease. Discrepancies reflected differences in operationalization of, for example, metabolic, cardiovascular, and mental health domains. Obesity thresholds influenced classification, with ~50% reclassified when BMI was combined with different fat distribution parameters, highlighting the sensitivity of early-stage assignment. CONCLUSIONS: EOSS and DMO provide complementary approaches to obesity classification, with differing classification patterns highlighting distinct concepts of obesity-related disease severity.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Obesity ; Concordance ; Categorization ; Operationalization ; Disease ; Severe Obesity ; Classification Of Obesity ; Body Mass Index; Clinical Endocrinologists; American Association
ISSN (print) / ISBN
1930-7381
e-ISSN
1930-739X
Journal
Obesity
Quellenangaben
Volume: 34,
Issue: 10,
Pages: 1989–1998
Publisher
Wiley
Publishing Place
111 River St, Hoboken 07030-5774, Nj Usa
Reviewing status
Peer reviewed
Institute(s)
Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG)
Grants
LeiCeM
Deutsche Forschungsgemeinschaft
Deutsche Forschungsgemeinschaft