In Paraguay’s capital, Asunción, The Lancet Diabetes & Endocrinology’s Commission for the Definition and Diagnosis of Clinical Obesity is on the verge of releasing new criteria aimed at distinguishing clinical obesity from its preclinical stages. The objective is to mitigate the negative stereotypes surrounding the term “obesity” and to underscore that it is indeed a disease, not merely a condition predisposing individuals to other health complications.
Ricardo Cohen, MD, PhD, who heads the Obesity and Diabetes Center at the Oswaldo Cruz German Hospital in São Paulo, Brazil, and serves as one of the two Latin American experts among the commission’s 60 members, shared insights on this initiative with Medscape Spanish edition.
The impending criteria recognize a preclinical phase characterized by cellular or tissue alterations that impact organ structure without affecting function. This stage can be gauged through parameters such as body mass index (BMI) or waist circumference.
Clinical obesity, as Cohen delineates, ensues when obesity starts impinging upon organ function and mobility, thus manifesting as a disease requiring active intervention. At this juncture, the health risks linked with excess adiposity become palpable and can be clinically substantiated.
At the XV Congress of the Latin American Obesity Societies (FLASO) and II Paraguayan Obesity Congress, various experts from the region conveyed their reservations regarding the proposed name change and its practical implications. They weighed the pros and cons of different terminologies that have been under consideration in recent years.
President of FLASO and director of the Nutrition program at the Faculty of Health Sciences of the Nuestra Señora de la Asunción Catholic University in Paraguay, Rafael Figueredo Grijalba, MD, acknowledged the existence of stigma surrounding obesity and its detrimental impact on self-esteem and clinical outcomes. However, he questioned whether altering the terminology alone would suffice to address these issues.
Proposed in 2016 by what is now the American Association of Clinical Endocrinology and the American College of Endocrinology, the term “adiposity-based chronic disease (ABCD)” garnered attention as an alternative to “obesity.” Dr. Violeta Jiménez, an internal medicine and endocrinology specialist, highlighted that the term “obese” can carry negative connotations and emphasized the significance of adipose tissue quantity, distribution, and function in determining health outcomes.
Dr. Paul Camperos Sánchez, an internal medicine and endocrinology specialist, advocated for a nuanced approach, emphasizing the importance of considering comorbidities and the multifaceted nature of obesity in treatment strategies.
In contrast, Dr. Julio Montero, a nutritionist and president of the Argentine Society of Obesity and Eating Disorders, favored the term “clinical obesity” for its medical specificity and ability to differentiate between individuals with high weight and those experiencing weight-dependent health issues.
Montero expressed concerns about the proposed term ABCD, noting its potential to oversimplify the complex interplay of factors contributing to obesity and its implications.
While debates surrounding nomenclature continue, the overarching goal remains to foster a more nuanced understanding of obesity and its management, moving beyond semantics to address the multifaceted challenges posed by this pervasive health issue.
- : public
