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New Framework Reclassifies Nearly 20 Percent of People as Having Obesity

By Elana Gotkine HealthDay Reporter

Medically reviewed by Carmen Pope, BPharm. Last updated on July 10, 2025.

WEDNESDAY, July 9, 2025 -- The European Association for the Study of Obesity (EASO) framework may offer a more sensitive measure of obesity than traditional body mass index (BMI), according to a study published online July 7 in the Annals of Internal Medicine.

Dror Dicker, M.D., from Tel Aviv University in Israel, and colleagues aimed to describe the distribution of overweight and obesity and determine the prevalence of complications and association of obesity with all-cause mortality using data from the National Health and Nutrition Examination Survey from 1999 to 2018 linked to mortality data. Obesity defined using BMI categories was compared to the new EASO definition.

The study population included 44,030 adults aged 18 to 79 years. The researchers found that 18.8 percent of adults who were previously defined as having overweight based on BMI alone were now considered persons with obesity (PWO) based on the new EASO definition. The newly identified PWO had a similar mortality risk as those with normal weight, while risk was elevated among persons with a BMI of 30 kg/m² or higher (hazard ratio, 1.19). A higher risk was seen among the newly identified PWO compared with persons with normal weight who did not have major morbidities (hazard ratio, 1.50), although this higher risk was no greater than that seen among persons with normal weight and comorbidities (hazard ratio, 1.74). Compared with persons with overweight according to the new EASO framework and the traditional BMI definition, excess mortality risk was seen among PWO.

"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," the authors write.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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Posted July 2025

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