Implications of the European Association for the Study of Obesity’s New Framework Definition of Obesity: Prevalence and Association With All-Cause Mortality
Authors' conclusion
The new EASO framework may provide a more sensitive tool to diagnose obesity than the traditional BMI definition, but whether these newly identified adults with obesity would benefit comparably to obesity treatment as those traditionally included in treatment trials is uncertain.
Study context
- Population
- Representative sample of US adults aged 18 to 79 years, NHANES 1999–2018
- Participants
- 44,030 participants
- Exposure
- European Association for the Study of Obesity (EASO) framework definition of obesity vs body mass index (BMI) categories
- Outcome
- Prevalence of obesity reclassification and all-cause mortality
Methodological detailsNHANES 1999–2018 linked to mortality data, Limitations: residual confounding; body weight assessed at a single time point
- NHANES 1999–2018 linked to mortality data
- Limitations: residual confounding; body weight assessed at a single time point
Main finding
As reported in the abstract
All-cause mortality
Each group vs normal weightHazard ratio (95% CI)
Newly identified PWO
0.98(0.87–1.10)
BMI ≥30 kg/m²
1.19(1.08–1.32)
- Adults overweight by BMI alone reclassified as persons with obesity (PWO) by new EASO definition
- 18.8%
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| All-cause mortality vs normal weight without major morbiditiesNewly identified PWOvs Normal weight without major morbidities | 1.50 (1.20–1.88) | |
| All-cause mortality vs normal weight without major morbiditiesNormal weight with comorbiditiesvs Normal weight without major morbidities | 1.74 (1.34–2.22) | |
| 0.512Hazard ratio (log scale) |
All-cause mortality vs normal weight without major morbidities
- Higher risk among newly identified PWO no greater than among normal weight with comorbidities
All-cause mortality, PWO vs overweight
- Excess risk among PWO vs overweight by both new EASO framework and traditional BMI definition
Most prevalent complications among newly identified PWO
- Hypertension
- 79.9%
- Arthritis
- 33.2%
- Diabetes
- 15.6%
- CVD
- 10.5%
Original publication
Implications of the European Association for the Study of Obesity’s New Framework Definition of Obesity: Prevalence and Association With All-Cause Mortality. Ann Intern Med. Published 8 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →