Why should we screen for obesity and its comorbidities?

People living with obesity are at risk of developing multiple overlapping conditions, sometimes without any obvious symptoms. Early screening is critical, as many of these diseases progress silently. By the time symptoms appear, significant metabolic dysfunction and organ damage may have already occurred.

Chapter 1: How does metabolic dysfunction link obesity with other cardiometabolic diseases?

SC-GB-03706 Metabolism - How does metabolic dysfunction link obesity

Chapter 2: Why is early screening and intervention essential?

SC-GB-03717 Metabolism - Why is early screening and intervention essential

What tools are available to help diagnose obesity?

Diagnosis of obesity should be based on the recognition of abnormal and/or excessive fat accumulation and the clinical analysis of its present and potential effects on health.¹

Body mass index (BMI) is widely used by healthcare professionals for screening.

Expand all

BMI, body mass index; WHO, World Health Organization.

However, for a proper diagnosis, BMI alone is insufficient and does not capture body composition (fat vs. muscle) or distribution of fat (central vs. peripheral).^1,4

Beyond BMI, there are additional anthropometric measurements and imaging tools for obesity assessment.

BMI, body mass index; CT, computerized tomography; DXA, dual-energy X-ray absorptiometry; MRI, magnetic resonance imaging.

In 2024, the European Association for the Study of Obesity (EASO) published a framework for diagnosing obesity in adults, to better align with the concept of obesity as an adiposity-based chronic disease (ABCD).⁹

EASO diagnostic framework^9,10

*BMI for Asian individuals living with obesity: ≥27.5 kg/m².

BMI, body mass index; EASO, European Association for the Study of Obesity; WtHR, waist-to-height ratio.

Disease staging in obesity: Why does it matter?

Staging frameworks are used in many diseases to help determine disease severity and support clinical decision-making.¹¹

Obesity disease staging methods, such as the Edmonton Obesity Staging System (EOSS), classify patients based on certain indicators to determine an individual’s health risk and optimise obesity treatment and management.¹²

The EOSS is a five-stage system for clinical prioritisation and management of obesity. The EOSS framework identifies and prioritises individuals who would most benefit from individualised, resource-intensive, and aggressive obesity management.^12,13

EOSS, Edmonton Obesity Staging System.

Progression of obesity to advanced stages is associated with increasingly severe alterations in organ structure and function, which can lead to end-organ damage and related complications.¹³

ABCD is a descriptive term that classifies obesity as a complex, chronic disease. It enables staging of the disease, and it avoids the stigma and confusion related to the differential use and multiple meanings of the word “obesity.”¹⁴

The Lancet Diabetes & Endocrinology Commission has also proposed a new diagnostic approach that focuses on measures of body fat and objective signs and symptoms of ill health. They have introduced two new categories of obesity: preclinical obesity and clinical obesity which can be explored further here.

Obesity

Burden of Obesity

Back to burden of obesity

Liver health

Understanding MASLD/MASH

Medscape. Guideline Essentials: 2024 European Association for the Study of Obesity Recommendations on the Diagnosis, Staging, and Management of Obesity in Adults. 2025. Available at: https://www.medscape.co.uk/viewarticle/guideline-essentials-2024-european-association-study-obesity-2024a1000mk0. Last accessed: April 2026.
World Health Organization. Obesity: Preventing and managing the global epidemic. 1997. Available at: https://iris.who.int/bitstream/handle/10665/42330/WHO_TRS_894.pdf. Last accessed: April 2026.
Riaz M, Lodhi S. Beyond BMI: Exploring obesity trends in the south Asian region. Obes Pillars. 2025;13:100156.
Aras S, et al. Indices of Central and Peripheral Obesity; Anthropometric Measurements and Laboratory Parameters of Metabolic Syndrome and Thyroid Function. Balkan Med J. 2015;32:414-420.
Parente EB. Is body mass index still a good tool for obesity evaluation? Arch Endocrinol Metab. 2016;60:507-509.
Sommer I, et al. The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis. Sci Rep. 2020;10:12699.
Meredith-Jones K, et al. Precision of DXA-Derived Visceral Fat Measurements in a Large Sample of Adults of Varying Body Size. Obesity (Silver Spring). 2018;26:505-512.
Leão C, et al. Testing the concurrent validity and reliability of a lipowise digital skinfold caliper to assess muscle mass in healthy young adults. Heliyon. 2023;9:e17569.
Busetto L, et al. A new framework for the diagnosis, staging and management of obesity in adults. Nat Med. 2024;30:2395-2399.
NICE. How should I confirm if a person is overweight or obese? 2025. Available at: https://cks.nice.org.uk/topics/obesity/diagnosis/identification-classification/. Last accessed: April 2026.
Bowman-Busato J, et al. Providing a common language for obesity: the European Association for the Study of Obesity obesity taxonomy. Int J Obes (Lond). 2025;49:182-191.
Swaleh R, et al. Using the Edmonton Obesity Staging System in the real world: a feasibility study based on cross-sectional data. CMAJ Open. 2021;9:E1141-E1148.
Rubino F. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol. 2025;13:221-262.
Mechanick JI, et al. Adiposity-Based Chronic Disease as a New Diagnostic Term: The American Association of Clinical Endocrinologists and American College of Endocrinology Position Statement. Endocr Pract. 2017;23:372-378.