Recently, there has been a major focus on combating obesity. The Endocrine Society released clinical practice guideline for Pharmacological Management of Obesity in December 2014. This guideline provides evidence-based pharmacological recommendations for chronic weight management. In 2015, American Society of Bariatric Physicians (ASBP) released its Obesity Algorithm. The ASBP Obesity Algorithm addresses the definition of obesity, factors that contribute to obesity, the effect of sleep disorders and stress on obesity, the effects of medications on weight, review of available weight-management medications, and other important topics. 

Here is a summary of Endocrine Society and ASBP recommendations for recognizing and managing obesity. 

Definition and classification of obesity

ASBP defines obesity as “A chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”

Body mass index (BMI), percent body fat, waist circumference, or presence of adiposity-related disease are used to classify obesity. BMI is one of the most common methods used to classify obesity and it divides obesity into 5 categories:

BMI (kg/m²) 18.5 – 24.9: Normal weight

BMI 25.0 – 29.9: Overweight

BMI 30.0 – 34.9: Class I obesity

BMI 35.0 – 39.9: Class II obesity

BMI ≥ 40: Class III obesity

The formula for calculating BMI is BMI (kg/m²) = (weight in kg)/(height in meters)², or 703 x (weight in pounds)/(height in inches)²

The Endocrine Society recommends diet, exercise, and behavioral modification therapies for people with BMI greater than or to 25 kg/m², and consider adding pharmacotherapy when BMI is greater than or to 27 kg/m² with comorbidity or BMI over 30 kg/m². Bariatric surgery may be considered in patients with BMI greater than or equal to 35 kg/m² with comorbidity or BMI greater than 40 kg/m².

Next: Treatment of Obesity