The Edmonton obesity staging system (EOSS), is a 5-point ordinal classification system that considers comorbidity and functional status, in predicting mortality in a nationally representative US sample.
In analysis of three large independent data sets (NHANES, COOPER Study),
the Edmonton obesity staging system independently predicted increased mortality even after adjustment for contemporary methods of classifying adiposity. The Edmonton obesity staging system may offer improved clinical utility in assessing obesity-related risk and prioritizing treatment.
Association Between EOSS and Mortality Risk inAerobics Center Longitudinal Study (n = 29 533)www.drsharma.ca Kuk JL, et al. Appl. Physiol. Nutr. Metab. 2011;36: 570
EOSS Distribution Across BMI CategoriesNHANES III (1988-1994) 14% 8% 19% 10% 15% Class I 59% 5% 14% Overweight 17% 23 million 28% Class II 47% 64% 5% EOSS Stage 14% 14% 0 10 million Class EOSS Stage III 1 50 million 67% EOSS Stage 6 million 2www.drsharma.ca Padwal R, Sharma AM et al. CMAJ 2011
EOSS Case 1 24 year-old physically active female, BMI of 32 Kg/m2 no demonstrable risk factors, no functional limitations, or mental health issues Class I, Stage 0 Obesity - Focus on prevention of further weight gain - Health benefits of more aggressive obesity treatment likely marginalwww.drsharma.ca Sharma AM & Kushner RF, Int J Obes 2009
EOSS Case 2 32 year-old male BMI of 36 Kg/m2 hypertension, sleep apnea, depression Class 2, Stage 2 Obesity - Clear benefits of obesity treatmentwww.drsharma.ca Sharma AM & Kushner RF, Int J Obes 2009
EOSS Case 3 63 year-old male BMI of 74 Kg/m2 disabling osteoarthritis (wheel chair) severe hypoventilation, fibromyalgia, generalized anxiety disorder Class 3, Stage 4 Obesity - Aggressive obesity treatment unless deemed palliativewww.drsharma.ca Sharma AM & Kushner RF, Int J Obes 2009
Key Points• EOSS provides a rational framework for clinical prioritization and management• EOSS stage is a better predictor of obesity risk than BMI or waist circumference• Assessing EOSS stage should be part of the clinical assessment of obesity• Management strategies should be based on EOSS stagewww.drsharma.ca