Obesity score helps predict death risk - kind of long winded

lilRicki

An obesity scoring system developed in Edmonton to help predict the risk of dying for overweight and obese people could be used to prioritize patients for weight-loss surgery.

The Edmonton Obesity Staging System (EOSS) is modeled on similar scores used to predict the extent and severity of other diseases such as a cancer, heart disease and mental illness.

The new scale includes five stages of obesity based on traditional measurements such as body mass index and waist-to-hip ratios, as well as clinical measurements of medical conditions tied to obesity, such as Type 2 diabetes, hypertension and heart disease.

In Monday's issue of the Canadian Medical Association Journal, Dr. Arya Sharma of the University of Alberta and his co-authors used the tool to predict death with data from a U.S. population survey of 8,143 people who were followed for 16 years. About 77 per cent of them were overweight or obese.

The findings suggested the scoring system was a strong predictor of increasing mortality risk in both the overall population and among those eligible for weight-loss treatment known as bariatric surgery.

"Body mass index, which is widely used to categorize and assess patients with obesity, only measures how big you are — not how sick you are," Sharma said in a release.

"The importance of EOSS is that it puts an emphasis on individualized treatment needs depending on how at-risk the patient is, not how much they weigh. With a single piece of paper, physicians can rapidly assess needs, and as importantly, prioritize treatment resources such as surgery."

Prioritizing patients with higher scores and mortality risk may help maximize the benefits of surgery, the researchers said.

A related study published online Monday in the journal Applied Physiology, Nutrition and Metabolism categorized 6,000 obese Americans based on the Edmonton system and compared their risk of dying to 23,000 lean counterparts over a 16-year span.

Promote weight maintenance

Compared with those with normal weights, patients in Stage 2 or 3 were at higher risk of cardiovascular disease and death, but patients in Stage 0 or 1 were not, Prof. Jennifer Kuk of York University's School of Kinesiology & Health Science in Toronto and her co-authors found.

"Obese patients, particularly in EOSS stages 0 and 1, may be better served if physicians promoted weight maintenance, as opposed to weight loss, as it remains to be seen whether individuals in EOSS stages 2 and 3 will benefit from weight loss," the researchers said.

Factors such as weight at age 21, cardio respiratory fitness, reported dieting and fruit and vegetable intake were each associated with a higher risk for Stage 2 or 3.

"Our findings challenge the idea that all obese individuals need to lose weight," Kuk said.

The study was funded by the U.S. National Institutes of Health.

External Links

Obesity staging study, CMAJ

olivieB

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. Severe health issues can be difficult to foretell. Conventional wisdom, however, is that being overweight could be a predictor. Two studies, however, show that weight and health problems are not necessarily inexorably linked. Body mass index, however, does not necessarily foretell health. In fact, these studies indicate that the BMI scale does not correctly show early death, as previously believed. BMI and obesity may not predict health problems as BMI become controversial because many people, including physicians, have come to rely on its apparent numerical authority for medical diagnosis, but that was never the BMI's purpose; it is meant to be used as a simple means of classifying sedentary (physically inactive) individuals with an average body composition.

Two studies have recently been undertaken to measure the impact of obesity on health problems and early death. The data indicated that there was “no difference in death risks between normal-weight individuals and obese individuals” without other, underlying health problems. The takeaway from both of these studies is that obesity in and of itself does not necessarily put an individual at higher risk of early death. In short, it is possible to be “healthy” and still considered “obese” by the Body Mass Index scale.