Epidemiology and Natural History of Preclinical and Clinical Obesity: Insights From a UK Cohort.

The prevalence of preclinical obesity was 31.2% and clinical obesity was 36.6% in the UK Biobank cohort.

• Analysis performed on 502,233 adults enrolled in the UK Biobank.
• Obesity was categorized using the new definition from the Lancet Diabetes and Endocrinology Commission (LDEC).
• Most individuals with preclinical and clinical obesity were in the WHO overweight category.
• Clinical obesity was defined as adiposity-related dysfunction assessed via ICD10 codes, physical immobility, and abnormal laboratory values.
• Preclinical obesity was defined as obesity with no additional metabolic deficits.

Clinical obesity was more prevalent in men, elderly individuals, South Asians, and those with lower education or income levels.

• Demographic analysis was conducted across the 502,233 UK Biobank participants.
• Socioeconomic factors including education and income level were associated with clinical obesity prevalence.
• South Asian ethnicity was specifically identified as a group with higher clinical obesity prevalence.
• Age (elderly) and sex (male) were both independent demographic factors associated with higher clinical obesity prevalence.

Individuals with clinical obesity and no baseline CVD had an increased hazard of incident stroke, heart failure, and myocardial infarction.

• The analysis focused on individuals without baseline cardiovascular disease to assess incident CVD outcomes.
• Three specific CVD outcomes were evaluated: stroke, heart failure, and myocardial infarction.
• The study used retrospective cohort analysis with hazard ratios to assess CVD risk.
• Preclinical obesity did not carry the same elevated CVD risk as clinical obesity.

Traditional BMI-based obesity definitions have limitations in assessing body fat composition and adiposity complications, motivating the LDEC's new stratified definition.

• The Lancet Diabetes and Endocrinology Commission (LDEC) issued a new obesity definition to address limitations of BMI-alone classification.
• The new definition stratifies obesity into preclinical and clinical groups based on presence of adiposity-related dysfunction.
• BMI alone does not adequately capture body fat composition or metabolic complications of adiposity.
• Clinical obesity requires evidence of adiposity-related dysfunction via ICD10 codes, physical immobility, or abnormal laboratory values.