Three researchers from Pennington Biomedical Research Center served on the Lancet Commission on Clinical Obesity , a global group that generated a new approach to diagnosing clinical obesity. The diagnosis is based on evaluations in addition to body mass index, or BMI, such as measures of excess body fat and objective signs and symptoms of ill health at the individual level.
"I'm very proud this is taking place at the Pennington Biomedical Research Center in my hometown of Baton Rouge, Louisiana. Pennington has been at the forefront of cutting-edge biomedical research, which of course saves lives and improves public health around the world," U.S. Sen. Bill Cassidy said. "The Lancet Commission's crucial work will help immensely – it will help us to better understand obesity and that will, in turn, inform policy making in Washington, D.C."
The Lancet Commission on Clinical Obesity was made up of 56 individuals from around the world, including Dr. John Kirwan , Executive Director and George A. Bray, Jr. Endowed Super Chair in Nutrition; Dr. Eric Ravussin , LSU Boyd Professor and Douglas L. Gordon Chair in Diabetes and Metabolism; and Dr. Philip Schauer , Director of the Metamor Institute and United Companies Life Insurance Co./Mary Kay and Terrell Brown Chair.
"We are honored and excited to be part of this global consensus – defining and diagnosing clinical obesity," Dr. Kiwan said. "Pennington Biomedical has been a leader in obesity research for decades now. We've been involved in the development of most of the current obesity behavioral and treatment programs, and we continue to research new approaches. We have been part of all the drugs that have been developed and are currently being used to treat obesity, and lastly, we have been pioneers in the bariatric surgery space in finding new ways to treat patients who have extreme obesity."
By providing a medically coherent framework for obesity diagnosis, the Commission aimed to settle the ongoing dispute around the idea of obesity as a disease, which has been at the center of one of the most controversial and polarizing debates in modern medicine.
"We now have a disease, which is called clinical obesity, and it should be taken seriously. It should be managed," Dr. Ravussin said. "Finally, we have efficacious and safe pharmacological approaches to obesity, which has not been the case in the history of the treatment of obesity. I think that it was important to have new definitions, as well as new diagnoses, to make it easier for clinicians to treat people with obesity."
The Commission provides a new model for disease diagnosis in obesity based on objective measures of illness at the individual level:
- Clinical obesity is defined as a condition of obesity associated with objective signs and/or symptoms of reduced organ function, or significantly reduced ability to conduct standard day-to-day activities, such as bathing, dressing, eating and continence, directly due to excess body fat. People with clinical obesity should be considered as having an ongoing chronic disease and receive appropriate management and treatments.
- Pre-Clinical obesity is a condition of obesity with normal organ function. People living with pre-clinical obesity therefore do not have ongoing illness, although they have a variable but generally increased risk of developing clinical obesity and several other non-communicable diseases in the future, including type 2 diabetes, cardiovascular disease, certain types of cancer and mental illness, among others. As such, they should be supported to reduce the risk of potential disease.
The Commission's reframing of obesity is designed to ensure that all people living with obesity receive appropriate health advice and evidence-based care when needed, with different strategies for clinical obesity and pre-clinical obesity.
"We have all these great tools now," Dr. Schauer said. "We have this much more precise, accurate, clinically relevant diagnosis, so now, nothing should hold us back from an international perspective, to really hone in on this disease – obesity – and provide those who need it the most – those with clinical obesity – provide them with the tools to improve their lives, and for many of them to extend their lives"
The proposal, endorsed by more than 75 medical organizations around the world and published in The Lancet Diabetes & Endocrinology, is designed to address limitations in the traditional definition and diagnosis of obesity that hinder clinical practice and healthcare policies, resulting in individuals with obesity not receiving the care they need.
"I think it's an honor, out of 56 commissioners, to have three coming from Pennington Biomedical, which is recognition that this Center is at the forefront when it comes to obesity diagnosis, as well as obesity treatment," Dr. Ravussin said.
Dr. Schauer said, "Pennington Biomedical was the most represented of all the institutions on the globe, and we're also very pleased to be one of the sites chosen to launch the information released by the Commission."
In addition to the three commissioners, Pennington Biomedical's Dr. Steven Heymsfield , Professor of Metabolism & Body Composition, consulted with the commission on the latest tools and technologies for measuring body composition. Dr. Heymsfield is a world leader in body composition assessment, metabolism and a physician scientist, GLP-1 agonists, which are used to treat type 2 diabetes and can help with weight loss.
"Dr. Heymsfield has been a pioneer in the development of tools like DEXA, and he is a leading investigator in the discovery of these 3D optical imaging systems, which allow you to assess body composition using your cell phone," Dr. Kirwan said. "This is a very convenient tool, widely available through software download to physicians and practitioners, and holds the potential of being a widely used tools for diagnosing clinical obesity."
