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Tool Helps Decide When to Get Weight Loss Surgery

Study Shows EOSS Tool Predicts Health Risks of Obese Patients

Staging Obesity-Related Health Risks continued...

For example, a person at stage 1 on the EOSS might be obese with borderline high blood pressure or prediabetes. They could also have occasional aches and pains, fatigue, or they might get short of breath after mild physical activity, like climbing a flight of stairs.

A person at stage 3, on the other hand, might be the same size, but they've already had a heart attack or stroke, they can't move around very well, and they may have poor quality of life.

To test the tool, the researchers applied it to nearly 8,000 Americans who took part in the government's ongoing National Health and Nutrition Examination Surveys (NHANES) from 1988 to 2004.

Each person who met the definition of being overweight, meaning they had a height and weight that gave them a BMI over 25, was also given an EOSS score.

The stages were assigned based on whether they also had diabetes, high blood pressure, high cholesterol, osteoarthritis, liver or kidney disease, trouble moving around, metabolic syndrome, and a large waist and high triglycerides.

A person's size, the study found, wasn't a very good predictor of how healthy they were.

More than three-quarters of the overweight and obese people in the study received scores of 1 or 2 on the EOSS scale.

And when researchers cross-referenced their work against death records, they found that BMI wasn't a reliable predictor of a person's death risk, but their EOSS score was.

About 90% of people who were classified as stage 1 when they started the study, for example, were still alive more than 17 years later, compared to roughly 55% of people who were at EOSS stage 3.

Compared to people with an EOSS score of 0 or 1, meaning they had few health problems, those at stage 2 had a roughly 60% increased risk of death, and those at stage 3 had nearly three times the risk of dying over the next 20 years.

Doctors say the study, which is published in the Canadian Medical Association Journal, doesn't mean that people shouldn't worry about weight loss.

"The likelihood of having an obesity-related health problem," such as heart disease or diabetes, "increases with your BMI," Sharma says.

But he says size clearly isn't the only determinant of health. "Even at the highest category of weight [having a BMI over 40] there are still about 20% of people who have no problems."

Though the tool needs further testing, researchers hope it may one day help patients who are healthy, and their doctors, make peace with their extra pounds, whatever their particular number may be.

"On the other hand, if someone has a BMI of 28 or 29 and their EOSS is 2 or 3, then you start to say, well this person has a lot of accumulated illnesses stemming from their weight," says study researcher Raj S. Padwal, MD, associate professor in the department of medicine at the University of Alberta. "You'd say, 'we really need to get on this.'"


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