# Classification of Obesity Based on Weight History: Perceptions of People With Obesity

## TL;DR

A new obesity classification based on lifetime maximum weight is seen as helpful by people with obesity for setting realistic goals and reducing stigma.

## Contribution

This is the first study confirming that the ABESO/SBEM classification is perceived as a useful clinical tool by people with obesity.

## Key findings

- 64% of participants had never been asked about their maximum weight by healthcare professionals.
- 82% found the new classification useful for changing perceptions about obesity treatment.
- The classification was perceived to help set realistic goals and reduce stigma.

## Abstract

Two Brazilian medical societies have proposed a new classification of obesity based on the maximum weight attained in an individual's lifetime, to be used in the clinical evaluation of individuals undergoing obesity treatment. This classification, which applies to adults aged 18 to 65 years, categorises people with obesity (PwO) who lose a certain percentage of their weight as having either ‘reduced’ or ‘controlled’ obesity. While the classification aims to improve patient care, there is limited data on PwO perceptions. To explore this, a cross‐sectional online survey was conducted with 500 PwO, including an explanation and clinical case of the new classification. The survey revealed that 64% of participants had never been asked by a healthcare professional (HCP) about their maximum weight. After knowing the new classification, 82% found it useful for changing perceptions about obesity treatment; 66% felt it would encourage them to seek treatment; 63% believed it would help with treatment maintenance; and 74% indicated they would feel better achieving ‘controlled obesity,’ even if the weight loss fell short of their goals. A majority agreed that the classification could help establish realistic goals (77%) and reduce biases from HCPs (69%). Overall, PwO perceived the classification as beneficial for encouraging treatment and reducing stigma.

What is already known about this subject
○Obesity is a chronic and recurrent disease, with efforts to lose weight often counteracted by biological mechanisms that slow down weight loss and contribute to recurrent weight gain.○Modest weight loss, particularly a reduction of 5% or more, can improve obesity‐related comorbidities and overall quality of life, with greater benefits observed for weight loss exceeding 10%.○Based on the above premises, two Brazilian medical societies—the Brazilian Association for the Study of Obesity (ABESO) and the Brazilian Society of Endocrinology and Metabolism (SBEM)—proposed a new classification of obesity based on the maximum weight attained in life. This classification designates individuals who have lost a certain percentage of their weight as having ‘reduced’ or ‘controlled’ obesity, serving as an additional tool to enhance understanding of the disease and facilitate discussions about treatment.
What this study adds
○Despite being a key information for understanding weight trajectories, maximum weight attained in life is rarely asked by healthcare professionals. In fact, 64% of individuals living with obesity reported never being asked about it, although 94% stated they were certain or almost certain of their maximum weight.○Despite evidence indicating modest weight loss improves health outcomes, 65% of individuals living with obesity believe that reaching a normal body mass index is necessary for improving their health and quality of life, highlighting that important clinical information is not reaching its target audience.○This is the first study to confirm that the ABESO/SBEM classification was perceived as a useful tool in clinical practise by individuals living with obesity, for: (1) setting realistic goals, (2) encouraging the pursuit and maintenance of obesity treatment, and (3) reducing stigma. Individuals living with obesity generally agreed that the classification should be adopted by health professionals.

What is already known about this subject
○Obesity is a chronic and recurrent disease, with efforts to lose weight often counteracted by biological mechanisms that slow down weight loss and contribute to recurrent weight gain.○Modest weight loss, particularly a reduction of 5% or more, can improve obesity‐related comorbidities and overall quality of life, with greater benefits observed for weight loss exceeding 10%.○Based on the above premises, two Brazilian medical societies—the Brazilian Association for the Study of Obesity (ABESO) and the Brazilian Society of Endocrinology and Metabolism (SBEM)—proposed a new classification of obesity based on the maximum weight attained in life. This classification designates individuals who have lost a certain percentage of their weight as having ‘reduced’ or ‘controlled’ obesity, serving as an additional tool to enhance understanding of the disease and facilitate discussions about treatment.

Obesity is a chronic and recurrent disease, with efforts to lose weight often counteracted by biological mechanisms that slow down weight loss and contribute to recurrent weight gain.

Modest weight loss, particularly a reduction of 5% or more, can improve obesity‐related comorbidities and overall quality of life, with greater benefits observed for weight loss exceeding 10%.

Based on the above premises, two Brazilian medical societies—the Brazilian Association for the Study of Obesity (ABESO) and the Brazilian Society of Endocrinology and Metabolism (SBEM)—proposed a new classification of obesity based on the maximum weight attained in life. This classification designates individuals who have lost a certain percentage of their weight as having ‘reduced’ or ‘controlled’ obesity, serving as an additional tool to enhance understanding of the disease and facilitate discussions about treatment.

What this study adds
○Despite being a key information for understanding weight trajectories, maximum weight attained in life is rarely asked by healthcare professionals. In fact, 64% of individuals living with obesity reported never being asked about it, although 94% stated they were certain or almost certain of their maximum weight.○Despite evidence indicating modest weight loss improves health outcomes, 65% of individuals living with obesity believe that reaching a normal body mass index is necessary for improving their health and quality of life, highlighting that important clinical information is not reaching its target audience.○This is the first study to confirm that the ABESO/SBEM classification was perceived as a useful tool in clinical practise by individuals living with obesity, for: (1) setting realistic goals, (2) encouraging the pursuit and maintenance of obesity treatment, and (3) reducing stigma. Individuals living with obesity generally agreed that the classification should be adopted by health professionals.

Despite being a key information for understanding weight trajectories, maximum weight attained in life is rarely asked by healthcare professionals. In fact, 64% of individuals living with obesity reported never being asked about it, although 94% stated they were certain or almost certain of their maximum weight.

Despite evidence indicating modest weight loss improves health outcomes, 65% of individuals living with obesity believe that reaching a normal body mass index is necessary for improving their health and quality of life, highlighting that important clinical information is not reaching its target audience.

This is the first study to confirm that the ABESO/SBEM classification was perceived as a useful tool in clinical practise by individuals living with obesity, for: (1) setting realistic goals, (2) encouraging the pursuit and maintenance of obesity treatment, and (3) reducing stigma. Individuals living with obesity generally agreed that the classification should be adopted by health professionals.