Centro de Obesidade, Hospital 9 de Julho, São Paulo, SP, Brasil,
Grupo de Obesidade e Síndrome Metabólica, Departamento de Endocrinologia e Metabolismo, Universidade de São Paulo, São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2022 Apr 28;66(2):139-151. doi: 10.20945/2359-3997000000465. Epub 2022 Apr 11.
Obesity is a chronic disease associated with impaired physical and mental health. A widespread view in the treatment of obesity is that the goal is to normalize the individual's body mass index (BMI). However, a modest weight loss (usually above 5%) is already associated with clinical improvement, while weight losses of 10%-15% bring even further benefits, independent from the final BMI. The percentage of weight reduction is accepted as a treatment goal since a greater decrease in weight is frequently difficult to achieve due to metabolic adaptation along with environmental and lifestyle factors. In this document, the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO) propose a new obesity classification based on the maximum weight attained in life (MWAL). In this classification, individuals losing a specific proportion of weight are classified as having "reduced" or "controlled" obesity. This simple classification - which is not intended to replace others but to serve as an adjuvant tool - could help disseminate the concept of clinical benefits derived from modest weight loss, allowing individuals with obesity and their health care professionals to focus on strategies for weight maintenance instead of further weight reduction. In future studies, this proposed classification can also be an important tool to evaluate possible differences in therapeutic outcomes between individuals with similar BMIs but different weight trajectories.
肥胖是一种与身心健康受损相关的慢性疾病。在肥胖治疗中，一种普遍的观点是，目标是使个体的体重指数（BMI）正常化。然而，适度的体重减轻（通常超过 5%）已经与临床改善相关，而体重减轻 10%-15%则带来更大的益处，与最终的 BMI 无关。体重减轻的百分比被接受为治疗目标，因为由于代谢适应以及环境和生活方式因素，体重的更大减少通常难以实现。在本文件中，巴西内分泌学会和代谢学会（SBEM）和巴西肥胖与代谢综合征研究学会（ABESO）提出了一种新的肥胖分类方法，基于一生中达到的最大体重（MWAL）。在这种分类中，体重减轻特定比例的个体被归类为“减轻”或“控制”肥胖。这种简单的分类——并非旨在取代其他分类方法，而是作为辅助工具——可以帮助传播源于适度体重减轻的临床获益概念，使肥胖患者及其医疗保健专业人员能够专注于体重维持策略，而不是进一步减轻体重。在未来的研究中，这种分类方法也可以成为评估具有相似 BMI 但不同体重轨迹的个体之间治疗效果差异的重要工具。
