The Obesity Society applauds the work of The Lancet Diabetes & Endocrinology Commission on Diagnostic Criteria of Clinical Obesity

ROCKVILLE, Md. -- The Obesity Society (TOS) applauds the work of The Lancet Diabetes & Endocrinology Commission on Diagnostic Criteria of Clinical Obesity to refine the definition of obesity and establish a framework for diagnosing other chronic diseases caused by excess adiposity. Several prominent experts in obesity and related metabolic diseases who are members of TOS served on the Commission offering scientific and clinical expertise.  The Lancet Commission framework aims to address challenges with the traditional definition and diagnosis of obesity that impede clinical practice and access to care for people living with obesity. Given the complexities of obesity, this is an important first step in reaching a consensus on diagnostic criteria, many of which will inevitably undergo further clarification and modification as additional research emerges. 

“Based on the available science and evidence generated over the past several decades, the position of the Obesity Society is that obesity is a chronic disease,” stated TOS President Marc-André Cornier, MD, FTOS. “Defining obesity as an illness rather than a chronic disease and introducing elements such as “clinical” and “preclinical” obesity may be confusing for many practitioners, patients, the public, researchers, payors, and policymakers. While TOS endorses bringing these important issues to the forefront, and the challenges of a clear and evidence-based definition are significant, several elements of a universal clinical definition remain that will require additional consideration.”  

The Obesity Society also agrees with the need to develop and validate more accurate and readily available clinical tools to diagnose obesity and its complications. In 2024 the International Obesity Collaborative, composed of TOS and other leading obesity organizations, released a consensus statement on Body Mass Index or BMI, a number that relates a person’s weight to their height.  

“Despite its limitations, BMI is still an appropriate and inexpensive tool to screen for obesity in the clinic. However, when used alone BMI does not define the disease of obesity or replace clinical judgment,” noted Cornier. Proposed measurement modalities to provide a more definitive diagnosis of obesity, including dual x-ray absorptiometry (commonly known as DEXA), bioimpedance analysis (BIA), magnetic resonance imaging (MRI), and others still require validation of clinically appropriate cut-offs, equitable access for the average practitioner, and establishment of appropriate reimbursement.  

TOS is committed to working with the international community as new evidence emerges to better understand how excess adiposity impacts the physical and psychological well-being of our patients and how to personalize management using all therapeutic tools available, from lifestyle to medications to surgery and other procedures. 

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The Obesity Society (TOS) is the leading organization of scientists and health professionals devoted to understanding and reversing the epidemic of obesity and its adverse health, economic, and societal effects. Combining the perspective of researchers, clinicians, policymakers, and patients, TOS promotes innovative research, education, and evidence-based clinical care to improve the health and well-being of all people with obesity. For more information, visit www.obesity.org.