Yesterday I had the pleasure of speaking to a group of Japanese colleagues from the Sapporo Medical University on the Edmonton Obesity Staging System (EOSS) and the recently published Etiological Framework for Obesity Assessment. The evening was chaired by Professor Kazuaki Shimamoto, who I have had the pleasure of meeting on several previous visits to Japan.
In my discussions with the participants it became immediately obvious that our proposed clinical staging of obesity can also be applied to obese patients in Japan, albeit using the lower BMI cutoff of 25 used to define obesity in this population.
Given the large number of nephrologists and cardiologists in the audience, I also found that the edema analogy, which I now often use to describe the state of excess caloric balance (or caloric “retention”), very much resonates with clinicians and provides an immediately understandable framework for approaching patients presenting with excess weight gain.
This evening I also plan to meet with a number of colleagues from Tokyo, who have previously attended the International Cardiovascular Expert Fora that I had organised during my time at McMaster University. These fora, which brought together a select group of clinical researchers from across several European and Asian countries, continues to be an interesting network of friends around the world, who always provide a sounding board for some of the issues that are relevant to cardiovascular and metabolic risk management.
As obesity rates continue to grow around the world, it is becoming painfully obvious that much needs to be done to address this issue at a global level. While we hope and wait for preventive measures to kick in, there is no doubt that the access to proper evidence-based obesity management remains a dire challenge in virtually all medical systems.
I am certainly grateful for the opportunity to share and learn from colleagues around the world on how best to approach this issue.
AMS
Tokyo, Japan
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