Authors
Tobias Hagemann, Arya M Sharma, Matthias Blüher, Anne Hoffmann
Published in
Obesity (Silver Spring, Md.). Sep 01, 2026. Epub Sep 01, 2026.
Abstract
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.
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.
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.
EOSS and DMO provide complementary approaches to obesity classification, with differing classification patterns highlighting distinct concepts of obesity-related disease severity.
PMID:
42680509
Bibliographic data and abstract were imported from PubMed on 02 Sep 2026.
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