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The number of overweight and obese patients in China ranks first in the world, especially the number of obese children
.
The "Clinical-based Multidisciplinary Diagnosis and Treatment Consensus on Obesity (2021 Edition)" invites experts in endocrinology, bariatric surgery, traditional Chinese medicine, nutrition, sports medicine and psychology to jointly formulate, in order to update and optimize obesity from a multidisciplinary perspective The concept of diagnosis and treatment of the disease
.
Regarding the clinical assessment of obesity, the consensus mainly involves the following
.
Clinical assessment of obesity (1) General indicators
.
BMI is the most commonly used indicator and recognized standard for the determination of obesity; waist circumference, hip circumference and waist-to-hip ratio can be used as preliminary judgment indicators to distinguish peripheral obesity from central obesity; fat content and body fat distribution can be further examined, and intra-abdominal fat is often used.
determination or dual energy X-ray examination
.
(2) Evaluation of metabolic indicators and obesity complications
.
Organ function measurement (such as heart, lung, liver, kidney) and metabolic status (glucose and lipid metabolism indexes) and endocrine indexes (such as thyroid function, gonadal function, and hypothalamic-pituitary function) can be evaluated according to specific conditions, and measured when necessary Inflammatory factors and immune markers, the degree of obesity was assessed according to the degree of metabolic abnormality or the number of complications
.
1.
BMIBMI (kg/m2) = body mass (kg)/height (m2)
.
At present, the diagnostic criteria for obesity are still not uniform due to regions, races, and different societies
.
WHO diagnostic criteria: BMI 18.
5-25.
0 kg/m2 is normal body weight, 25.
0-29.
9 kg/m2 is overweight, ≥30 kg/m2 is obese
.
In 1999, WHO issued a BMI classification standard for Asians, and BMI 25~29.
9 kg/m2 was diagnosed as degree I obesity, and BMI ≥ 30 kg/m2 was diagnosed as degree II obesity
.
The Chinese Obesity Working Group and the Chinese Diabetes Society defined BMI <18.
5 kg/m2 as underweight, BMI 18.
5-23.
9 kg/m2 as normal body weight, BMI 24.
0-27.
9 kg/m2 as overweight, and BMI >28.
0 kg /m2 is defined as obesity
.
2.
Waist circumference, hip circumference and waist-to-hip ratio The measurement of waist circumference and hip circumference is a simple auxiliary index commonly used in clinic to judge metabolic obesity and central obesity.
Some studies also suggest the value of neck circumference and wrist circumference in the diagnosis and treatment of obesity.
.
Waist to hip ratio = waist circumference / hip circumference
.
China currently refers to the WHO standard: adult male waist circumference ≥ 90 cm, adult female waist circumference ≥ 85 cm, or male and female waist-to-hip ratio > 1.
0 can be diagnosed as abdominal obesity
.
3.
Body fat content refers to the content of body fat or the percentage of fat in the total mass, which can be used to preliminarily assess the amount and distribution of body fat components.
The fat content of normal adult men accounts for 10%~20% of body mass, and women 15%~ 25%
.
The current methods for determining fat content include dual energy X-ray absorptiometry (DEXA), bioelectrical impedance (BIA), ultrasound, skinfold thickness method, and underwater weighing system method
.
DEXA can more accurately assess the content and distribution of fat, muscle and bone, and is currently a recognized detection method; BIA has errors and can be used as a preliminary screening application
.
At present, the body fat content of men is more than 25% and the body fat content of women is more than 30%
.
4.
Visceral Fat Area (VFA) As the gold standard for the diagnosis of abdominal obesity, VFA can accurately and intuitively reflect the accumulation of visceral fat.
The commonly used methods are abdominal CT and MRI examinations, and the subcutaneous fat area (SFA) can be measured at the same time, which is more accurate reflect fat distribution
.
However, due to the high cost, which limits clinical promotion, China refers to the WHO standard to diagnose abdominal obesity as VFA ≥ 80 cm2
.
5.
The standard body weight percentage is often used to judge obesity in children and special populations.
The standard body weight percentage = the actual body weight of the subject/standard body weight × 100%
.
Standard body mass percentages ≥120% and <125% were considered mild obesity, ≥125% and <150% were moderately obese, and ≥150% were severely obese
.
6.
Other related parameters calculated based on anthropological measurement indicators can also be used for the assessment of obesity, such as body shape index (ABSI) = waist circumference / (BMI × height), ABSI is an anthropological parameter proposed in 2012, and BMI can be combined It was a good predictor of obesity-related risk including cardiovascular events, and ABSI was significantly positively correlated with VFA
.
The texture of visceral fat (image characteristics of CT examination) has strong indicative significance in the metabolic outcome of obese patients and the prediction of surgical intervention efficacy
.
The above content is excerpted from: Endocrinology Branch of Chinese Medical Association, Diabetes Branch of Chinese Association of Traditional Chinese Medicine, Obesity and Diabetes Surgeons Committee of Surgeons Branch of Chinese Medical Doctor Association, Diabetes and Obesity Surgery Professional Committee of Chinese Research Hospital Association.
Consensus on diagnosis and treatment (2021 edition)[J].
Chinese Journal of Digestive Surgery,2021,20(11):1137-1152.
.
The "Clinical-based Multidisciplinary Diagnosis and Treatment Consensus on Obesity (2021 Edition)" invites experts in endocrinology, bariatric surgery, traditional Chinese medicine, nutrition, sports medicine and psychology to jointly formulate, in order to update and optimize obesity from a multidisciplinary perspective The concept of diagnosis and treatment of the disease
.
Regarding the clinical assessment of obesity, the consensus mainly involves the following
.
Clinical assessment of obesity (1) General indicators
.
BMI is the most commonly used indicator and recognized standard for the determination of obesity; waist circumference, hip circumference and waist-to-hip ratio can be used as preliminary judgment indicators to distinguish peripheral obesity from central obesity; fat content and body fat distribution can be further examined, and intra-abdominal fat is often used.
determination or dual energy X-ray examination
.
(2) Evaluation of metabolic indicators and obesity complications
.
Organ function measurement (such as heart, lung, liver, kidney) and metabolic status (glucose and lipid metabolism indexes) and endocrine indexes (such as thyroid function, gonadal function, and hypothalamic-pituitary function) can be evaluated according to specific conditions, and measured when necessary Inflammatory factors and immune markers, the degree of obesity was assessed according to the degree of metabolic abnormality or the number of complications
.
1.
BMIBMI (kg/m2) = body mass (kg)/height (m2)
.
At present, the diagnostic criteria for obesity are still not uniform due to regions, races, and different societies
.
WHO diagnostic criteria: BMI 18.
5-25.
0 kg/m2 is normal body weight, 25.
0-29.
9 kg/m2 is overweight, ≥30 kg/m2 is obese
.
In 1999, WHO issued a BMI classification standard for Asians, and BMI 25~29.
9 kg/m2 was diagnosed as degree I obesity, and BMI ≥ 30 kg/m2 was diagnosed as degree II obesity
.
The Chinese Obesity Working Group and the Chinese Diabetes Society defined BMI <18.
5 kg/m2 as underweight, BMI 18.
5-23.
9 kg/m2 as normal body weight, BMI 24.
0-27.
9 kg/m2 as overweight, and BMI >28.
0 kg /m2 is defined as obesity
.
2.
Waist circumference, hip circumference and waist-to-hip ratio The measurement of waist circumference and hip circumference is a simple auxiliary index commonly used in clinic to judge metabolic obesity and central obesity.
Some studies also suggest the value of neck circumference and wrist circumference in the diagnosis and treatment of obesity.
.
Waist to hip ratio = waist circumference / hip circumference
.
China currently refers to the WHO standard: adult male waist circumference ≥ 90 cm, adult female waist circumference ≥ 85 cm, or male and female waist-to-hip ratio > 1.
0 can be diagnosed as abdominal obesity
.
3.
Body fat content refers to the content of body fat or the percentage of fat in the total mass, which can be used to preliminarily assess the amount and distribution of body fat components.
The fat content of normal adult men accounts for 10%~20% of body mass, and women 15%~ 25%
.
The current methods for determining fat content include dual energy X-ray absorptiometry (DEXA), bioelectrical impedance (BIA), ultrasound, skinfold thickness method, and underwater weighing system method
.
DEXA can more accurately assess the content and distribution of fat, muscle and bone, and is currently a recognized detection method; BIA has errors and can be used as a preliminary screening application
.
At present, the body fat content of men is more than 25% and the body fat content of women is more than 30%
.
4.
Visceral Fat Area (VFA) As the gold standard for the diagnosis of abdominal obesity, VFA can accurately and intuitively reflect the accumulation of visceral fat.
The commonly used methods are abdominal CT and MRI examinations, and the subcutaneous fat area (SFA) can be measured at the same time, which is more accurate reflect fat distribution
.
However, due to the high cost, which limits clinical promotion, China refers to the WHO standard to diagnose abdominal obesity as VFA ≥ 80 cm2
.
5.
The standard body weight percentage is often used to judge obesity in children and special populations.
The standard body weight percentage = the actual body weight of the subject/standard body weight × 100%
.
Standard body mass percentages ≥120% and <125% were considered mild obesity, ≥125% and <150% were moderately obese, and ≥150% were severely obese
.
6.
Other related parameters calculated based on anthropological measurement indicators can also be used for the assessment of obesity, such as body shape index (ABSI) = waist circumference / (BMI × height), ABSI is an anthropological parameter proposed in 2012, and BMI can be combined It was a good predictor of obesity-related risk including cardiovascular events, and ABSI was significantly positively correlated with VFA
.
The texture of visceral fat (image characteristics of CT examination) has strong indicative significance in the metabolic outcome of obese patients and the prediction of surgical intervention efficacy
.
The above content is excerpted from: Endocrinology Branch of Chinese Medical Association, Diabetes Branch of Chinese Association of Traditional Chinese Medicine, Obesity and Diabetes Surgeons Committee of Surgeons Branch of Chinese Medical Doctor Association, Diabetes and Obesity Surgery Professional Committee of Chinese Research Hospital Association.
Consensus on diagnosis and treatment (2021 edition)[J].
Chinese Journal of Digestive Surgery,2021,20(11):1137-1152.
