6
Diagnosis
TOP 10 TAKEAWAY MESSAGES:
Obesity Classification and Consequences
1. For the general population, body mass index (BMI) ≥25 kg/m
2
is
considered pre-obesity/overweight; BMI ≥30 kg/m
2
is considered
obesity.
2. BMI has limitations in assessing adiposity in individuals with
increased muscle mass, decreased muscle mass, and in men
versus women.
3. For individuals, accurately determining percent body fat, android
fat, and visceral fat is a better assessment of adiposity compared
to BMI alone.
4. Central obesity is defined as waist circumference (WC) >40
inches (102 cm) for men and >35 inches (88 cm) for women (>90
cm for Asian men; >80 cm for Asian women.)
5. Waist circumference is well-correlated with the risk of metabolic
and cardiovascular disease.
6. Fat mass disease results in pathologic mechanical and physical
forces leading to adverse clinical outcomes (e.g., sleep apnea,
orthopedic problems).
7. Sick fat disease (SFD) (adiposopathy) results in pathologic
endocrine and immune responses that promote the most
common metabolic diseases encountered in clinical medical
practice (e.g., diabetes mellitus, high blood pressure,
dyslipidemia).
8. Anatomic adiposopathic changes with obesity include adipocyte
hypertrophy, adipose tissue expansion, increased energy storage
in multiple fat depots, and increased fat deposition in body
organs.
9. Functional adiposopathic changes with obesity include adipose
hypoxia, increased reactive oxygen species, extracellular
matrix abnormalities, intra-organelle dysfunction, neurological
changes, and immunopathic/endocrinopathic responses.
10. The degree by which adiposopathy results in metabolic disease
largely depends on the interactions and crosstalk with other
body organs.
