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DOI: 10.1055/a-2606-0632
Neue Kriterien zur Definition und Diagnostik der Adipositas?
New criteria for the definition and diagnosis of Obesity?
Zusammenfassung
Adipositas ist eine sehr häufige, chronisch fortschreitende Erkrankung, die zu einer reduzierten Lebenserwartung und einer eingeschränkten Lebensqualität führen kann. Bisher wird Adipositas über den Body-Mass-Index (BMI) definiert und berücksichtigt nicht den individuellen Gesundheitszustand. Diese Definition wird aber der Heterogenität der Erkrankung und der Bedeutung der gestörten Funktion und Verteilung des Fettgewebes nicht gerecht. Deshalb hat eine aus Experten und Expertinnen zusammengesetzte globale Lancet Commission on Clinical Obesity einen neuen und differenzierteren Ansatz zur Diagnose der Adipositas vorgeschlagen. Dieser basiert zusätzlich zum BMI auf anderen Messgrößen für Körperfettvermehrung, wie dem Taillenumfang, dem Verhältnis aus Bauchumfang und Körpergröße, oder der direkten Messung des Körperfetts. Zusätzlich schlägt die Kommission vor, objektive Anzeichen und Symptome von Erkrankungen sowie funktionelle Einschränkungen auf individueller Ebene zu berücksichtigen und daraus „präklinische“ und „klinisch“ Adipositas zu unterscheiden. Dieser Ansatz ist nicht neu, aber trotzdem aktuell, da der Bedarf für eine bessere und Schweregrad-stratifizierte Therapie auch in Deutschland immer noch sehr hoch ist.
Abstract
Obesity is a highly prevalent, chronic progressive disease that can reduce life expectancy and quality of life. Current BMI-based measures of obesity can both underestimate and overestimate adiposity and provide inadequate information about the individual health status. In addition, the obesity definition by BMI does not reflect the importance of impaired adipose tissue function and adverse fat distribution. Therefore, the Lancet Commission on Clinical Obesity recently proposed a novel more sophisticated approach for the diagnosis of obesity. The suggested definition considers in addition to the BMI parameters of adiposity and fat distribution such as waist circumference, waist-to-height ratio or direct measures of body fat content. In addition, the Commission suggested to include objective symptoms of diseases and functional impairments into the obesity definition to distinguish preclinical from clinical obesity. This approach is not new, but still timely, because there is also in Germany the need for a better and disease burden stratified treatment of people living with obesity.
Publication History
Article published online:
15 September 2025
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