Definition and diagnostic criteria of clinical obesity

Clinical obesity: chronic, systemic illness with altered function of tissues, organs, the entire individual, or a combination, due to excess adiposity; preclinical obesity: excess adiposity with preserved function of other tissues and organs and generally increased risk of clinical obesity and other non-communicable diseases

Use BMI only as a surrogate of health risk at population level, for epidemiological studies or screening, not as an individual measure of health

Confirm excess adiposity by direct body fat measurement or ≥1 anthropometric criterion (eg, waist circumference, WHR, waist-to-height ratio) in addition to BMI; with BMI >40 kg/m² excess adiposity can be assumed

Assess people with confirmed obesity for clinical obesity

Diagnose clinical obesity by reduced organ or tissue function due to obesity and/or substantial, age-adjusted limitations of daily activities due to obesity

Clinical obesity: timely, evidence-based treatment to improve (or remit) manifestations and prevent end-organ damage; preclinical obesity: evidence-based counselling, health monitoring and, when applicable, intervention to reduce risk

Policy makers should ensure adequate and equitable access to evidence-based treatments for clinical obesity; public health strategies must be evidence-based, not blame individual responsibility

Health-care professionals and policy makers should be trained to address weight-based bias and stigma