Table 3.
Comments from participants on specific statements.
| Statement | Comments |
|---|---|
| Definitions of obesity | |
| Obesity is a complex disease | ‘I think the word "complex" has stagnated progress in policy and practice. It is almost as if practitioners and policymakers feel it is too challenging to address’ |
| Obesity is defined as abnormal or excessive adiposity that may impair, or present a risk to, health | ‘The term, may, needs to be removed. If there is no health impairment, there is no disease’ |
| ‘I think the term "defined" is out of place. We don't need to define obesity just like we don't define diabetes. We never say, "diabetes is defined". We just say, "Diabetes is a chronic, metabolic disease characterized by […]"’ | |
| Obesity is a chronic, complex disease defined by excessive adiposity that may impair health | Two participants highlighted that in German, obesity is synonymous with adiposity (adipositas) and that it could be confusing. |
| Another participant was in favour of the simpler ‘fat accumulation’ | |
| ‘I would like to have some reference to dysfunctional adipose tissue’ | |
| ‘Better adiposity than fat accumulation’ | |
| Obesity can be measured by calculating BMI | ‘BMI is an epidemiological tool which does not define the disease of obesity’ |
| BMI is useful over large population sizes but might not be particularly useful on an individual basis' | |
| ‘I would prefer EOSS’ | |
| Causes of obesity development | |
| Psychological factors are among the main causes of developing obesity | Participants noted that these were all factually correct, but not one of the main causes of obesity |
| Pre-existing medical conditions are among the main causes of developing obesity | |
| Endocrine disorders are among the main causes of developing obesity | |
| Medication is among the main causes of developing obesity | |
| An imbalance between energy intake and energy output is among the main causes of developing obesity | ‘Energy imbalance is a result of something, so it is not the primary cause of obesity’ |
| ‘This is more the result, not the cause in itself. The other factors may cause this imbalance’ | |
| ‘The imbalance is a symptom or a pathophysiologic mechanism, not the cause’ | |
| Factors exacerbating obesity | |
| An imbalance between energy intake and energy output is among the main factors that exacerbate obesity | ‘Again, this is a consequence and not a cause’ |
| Obesity treatment options | |
| Obesity treatment options should aim at weight loss | ‘Weight loss is a consequence of successful treatment not an objective’ |
| ‘Weight loss as such should not be an aim, especially not a number. Muscles are heavier than fat. If a person loses fat and gains muscles, that is a health improvement, and possible an increased weight’ | |
| Obesity management | All statements on management received consensus among participants |
| Medical complications of obesity | |
| Type 2 diabetes is among the main medical complications of obesity | Participants noted that obesity could equally be a complication of diabetes |
BMI: body mass index; EOSS: Edmonton Obesity Staging System.