Use Of The Edmonton Obesity Staging System South Asians?

Regular readers of these pages will recall our recent paper in PLoS showing increased susceptibility for cardiometabolic risk factors in South Asians at substantially lower body weights than in Caucasians. These findings are consistent with a large body of evidence suggesting that the BMI definition of ‘obesity’ should likely start a lower BMI levels in South Asian and East Asian populations.

In India, not too long ago, redefinition of ‘obesity’ with lower BMI cutoffs, resulted in a major reclassification of the ‘burden of obesity’ in that country.

There is, however, good reason to assume that even at this lower BMI cutoff, the relationship between BMI and actual risk is probably as poor in this population, as it has proven to be in Caucasian samples.

We there think it reasonable to propose that the Edmonton Obesity Staging Stystem, which characterizes obesity stages based on how ‘sick’ rather than simply on how ‘big’ a given patient may be, will also prove a better system to determine individual care plans than simply suggesting that everyone with a BMI that crosses a certain threshold to lose weight.

Since our recent papers on EOSS examined a predominantly white population, I very much hope that other investigators with access to South Asian or other ethnic populations will examine the relationship between EOSS and mortality in their subjects.

I would frankly be very surprised if their results turn out to be any different in that EOSS is a much better predictor of individual risk than BMI.

Edmonton, Alberta

Padwal RS, Pajewski NM, Allison DB, & Sharma AM (2011). Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne PMID: 21844111

Kuk JL, Ardern CI, Church TS, Sharma AM, Padwal R, Sui X, & Blair SN (2011). Edmonton Obesity Staging System: association with weight history and mortality risk. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme PMID: 21838602