# The Edmonton Obesity Staging System for Pediatrics (EOSS-P) in Mexican Children and Adolescents Living with Obesity: Beyond BMI Obesity Classes

## TL;DR

This study shows that Mexican children with obesity are often classified in the most severe stage of a comprehensive obesity staging system, highlighting the need to assess obesity beyond BMI.

## Contribution

The study adapts the Edmonton Obesity Staging System for Pediatrics (EOSS-P) to Mexican children and demonstrates its value in assessing obesity severity beyond BMI.

## Key findings

- Over half of the children were classified in the most severe stage (stage 3) of the EOSS-P.
- There is a weak association between EOSS-P staging and BMI-based obesity classification.

## Abstract

What are the main findings?
•More than half of the children were classified in stage 3, the most severe stage of the EOSS-P.•There is a weak association between EOSS-P staging and BMI-based obesity classification in children.

What is the implication of the main finding?
•The assessment of obesity in children should go beyond BMI and include metabolic, mechanical, mental, and social domains•The EOSS-P is a valuable tool for the comprehensive assessment of obesity that could be adapted to different contexts.

What are the main findings?
•More than half of the children were classified in stage 3, the most severe stage of the EOSS-P.•There is a weak association between EOSS-P staging and BMI-based obesity classification in children.

More than half of the children were classified in stage 3, the most severe stage of the EOSS-P.

There is a weak association between EOSS-P staging and BMI-based obesity classification in children.

What is the implication of the main finding?
•The assessment of obesity in children should go beyond BMI and include metabolic, mechanical, mental, and social domains•The EOSS-P is a valuable tool for the comprehensive assessment of obesity that could be adapted to different contexts.

The assessment of obesity in children should go beyond BMI and include metabolic, mechanical, mental, and social domains

The EOSS-P is a valuable tool for the comprehensive assessment of obesity that could be adapted to different contexts.

Background/Objectives: The Edmonton Obesity Staging System (EOSS) was developed to stage the obesity in adult populations. Subsequently, this staging system was designed for pediatric populations (EOSS-P). This study aimed to describe obesity severity using EOSS-P and correlate it with BMI classes in Mexican children and adolescents living with obesity. Methods: This is a cross-sectional analysis carried out with data from school-age children and adolescents living with obesity who were referred to the Pediatric Obesity Clinic at the Child Welfare Unit at the General Hospital of Mexico “Dr. Eduardo Liceaga”. Obesity was staged using the EOSS-P. To evaluate the association between obesity classes and each EOSS-P domain, as well as overall EOSS-P staging, we performed Bayesian ordered logistic regression models. Results: A total of 118 participants were included; 43.2% were female and 56.8% were male. Based on the overall EOSS-P staging, 56.8% of participants were classified as stage 3, while none were categorized as stage 0. Obesity class II-III was associated with higher odds for the mechanical (OR = 2.5), metabolic (OR = 1.9), and social (OR = 1.6) domains. Conclusions: Pediatric obesity assessment should extend beyond BMI to include the evaluation of metabolic, mechanical, and psychological domains, identifying health complications and barriers that may impact treatment effectiveness and adherence. The EOSS-P is a valuable tool for staging pediatric obesity based on these domains and can guide personalized clinical decision-making.