Carbone Federico, Després Jean-Pierre, Ioannidis John P A, Neeland Ian J, Garruti Gabriella, Busetto Luca, Liberale Luca, Ministrini Stefano, Vilahur Gemma, Schindler Thomas H, Macedo Maria Paula, Di Ciaula Agostino, Krawczyk Marcin, Geier Andreas, Baffy Gyorgy, Faienza Maria Felicia, Farella Ilaria, Santoro Nicola, Frühbeck Gema, Yárnoz-Esquiroz Patricia, Gómez-Ambrosi Javier, Chávez-Manzanera Emma, Vázquez-Velázquez Verónica, Oppert Jean-Michel, Kiortsis Dimitrios N, Sbraccia Paolo, Zoccali Carmine, Portincasa Piero, Montecucco Fabrizio
Department of Internal Medicine, University of Genoa, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, Genoa, Genoa, Italy.
Eur J Clin Invest. 2025 Aug;55(8):e70059. doi: 10.1111/eci.70059. Epub 2025 May 15.
Most forms of obesity are associated with chronic diseases that remain a global public health challenge.
Despite significant advancements in understanding its pathophysiology, effective management of obesity is hindered by the persistence of knowledge gaps in epidemiology, phenotypic heterogeneity and policy implementation.
This consensus statement by the European Society for Clinical Investigation identifies eight critical areas requiring urgent attention. Key gaps include insufficient long-term data on obesity trends, the inadequacy of body mass index (BMI) as a sole diagnostic measure, and insufficient recognition of phenotypic diversity in obesity-related cardiometabolic risks. Moreover, the socio-economic drivers of obesity and its transition across phenotypes remain poorly understood.
The syndemic nature of obesity, exacerbated by globalization and environmental changes, necessitates a holistic approach integrating global frameworks and community-level interventions. This statement advocates for leveraging emerging technologies, such as artificial intelligence, to refine predictive models and address phenotypic variability. It underscores the importance of collaborative efforts among scientists, policymakers, and stakeholders to create tailored interventions and enduring policies.
The consensus highlights the need for harmonizing anthropometric and biochemical markers, fostering inclusive public health narratives and combating stigma associated with obesity. By addressing these gaps, this initiative aims to advance research, improve prevention strategies and optimize care delivery for people living with obesity.
This collaborative effort marks a decisive step towards mitigating the obesity epidemic and its profound impact on global health systems. Ultimately, obesity should be considered as being largely the consequence of a socio-economic model not compatible with optimal human health.
大多数肥胖形式都与慢性疾病相关，这些慢性疾病仍然是一项全球性的公共卫生挑战。
尽管在理解肥胖的病理生理学方面取得了重大进展，但由于在流行病学、表型异质性和政策实施方面存在知识空白，肥胖的有效管理受到阻碍。
欧洲临床研究学会的这份共识声明确定了八个需要紧急关注的关键领域。主要差距包括肥胖趋势的长期数据不足、体重指数（BMI）作为唯一诊断指标的不足，以及对肥胖相关心脏代谢风险中表型多样性的认识不足。此外，肥胖的社会经济驱动因素及其跨表型的转变仍知之甚少。
全球化和环境变化加剧了肥胖的综合征性质，这需要一种整合全球框架和社区层面干预措施的整体方法。本声明主张利用人工智能等新兴技术来完善预测模型并应对表型变异性。它强调了科学家、政策制定者和利益相关者之间合作努力以制定量身定制的干预措施和持久政策的重要性。
该共识强调了统一人体测量和生化指标、营造包容性公共卫生叙事以及消除与肥胖相关污名的必要性。通过解决这些差距，该倡议旨在推进研究、改进预防策略并优化对肥胖患者的护理服务。
这一合作努力标志着朝着减轻肥胖流行及其对全球卫生系统的深远影响迈出了决定性的一步。最终，肥胖应被视为很大程度上是一种与最佳人类健康不相容的社会经济模式的后果。
