Usefulness of the Edmonton Obesity Staging System for stratifying the presence and severity of weight‐related health problems in clinical and community settings: A rapid review of observational studies

Abstract

This rapid review aimed to examine the usefulness of the Edmonton Obesity Staging System (EOSS) for stratifying the presence and severity of weight-related health problems in clinical and community settings. We searched PubMed, CINAHL and ProQuest for records from 2009 to May 2020. We considered observational studies in participants with overweight or obesity that investigated the risk of any clinical outcome associated with increasing EOSS. We reviewed and appraised 20 observational studies (cohort = 4, case series = 7, cross-sectional = 9) published between 2011 and 2020. Of 12 studies in clinical populations, the EOSS was most consistently associated with an increased risk of postoperative complications following bariatric surgery, especially for EOSS 3-4, and inversely associated with weight loss, treatment time and resolution of hypertension following bariatric surgery and clinical weight management. Of eight studies in community populations, the EOSS most consistently predicted mortality outcomes, especially for EOSS 3, and was associated with polypharmacy, service use and poorer work outcomes. Studies reported diverse EOSS definitions and outcomes, which slightly weakens the overall evidence base. The EOSS should be routinely used for predicting risks and benefits of surgical and nonsurgical weight management, but it should be applied with caution for population health planning.

Clinical usefulness of brief screening tool for activating weight management discussions in primary cARE (AWARE): A nationwide mixed methods pilot study

“…We developed a brief screening tool (‘EOSS-2 Risk Tool’) to identify previously undiagnosed weight related complications against published EOSS ≥2 criteria based on clinical information (reference standard) for potential application in general practice [ 3 ]. As there is no internationally consistent set of criteria with standardized cut-offs for classifying people into EOSS categories [ 17 ], we chose this reference standard which has been validated in an Australian sample of community-based ‘high risk’ individuals [ 3 ]. The tool consists of nine risk factor items including age, self-reported health status (quality of life, disability, bodily pain, and depression or anxiety), and family history (diabetes, hypertension, high sugar in blood/urine, and high cholesterol) relevant to the Australian population with overweight or obesity ( S1 Appendix ).…”

“…A score of 2 or higher on the EOSS indicates the presence of clinically significant weight related complications requiring clinical intervention. A rapid review of relevant studies concluded that the EOSS should be routinely used for predicting risks and benefits of surgical and non-surgical weight management [ 17 ]. However, it also highlighted the need for developing standardized tools for clinical settings based on a consistent set of criteria with standardized cut-offs for classifying people into EOSS categories.…”

Effect of an Antenatal Lifestyle Intervention on Dietary Inflammatory Index and Its Associations with Maternal and Fetal Outcomes: A Secondary Analysis of the PEARS Trial

“…We categorised maternal cardiometabolic markers including total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride concentrations, glucose, and blood pressure into low (stage 0) or some risk (stages ≥1). Different cut-offs have been used for the individual cardiometabolic markers in the EOSS, as detailed in the recent review by Atlantis et al, 2020 [ 39 ]. Women were given an EOSS score ≥1 if they met any of the following criteria: systolic blood pressure >130 mmHg, diastolic blood pressure >80 mmHg, fasting glucose ≥5.6 mmol/L, total cholesterol ≥5.2 mmol/L, LDL cholesterol >3.3 mmol/L, HDL cholesterol <1.6 mmol/L, and triglyceride ≥1.7 mmol/L.…”

Attentional Networks in Co-occurring Generalized Anxiety Disorder and Major Depression Disorder: Towards a Staging Approach to the Executive Control Deficits

“…This staging perspective is not surprising. Indeed, it dovetails with longstanding health care models of comorbidity, wherein, as a result of the mutual reinforcement between the symptoms of each disorder, the comorbidity between any pair of disorders (that is, physical and/or mental) is considered as more damaging than the impact of any one disorder alone (e.g., Addington et al, 2019;Atlantis et al, 2020;Feinstein and Wells, 1990;Ndetei et al, 2018 for mental health, see Bokma et al, 2020;Cramer et al, 2010;Kleiman and Riskind, 2012;Macdonald et al, 2016). Research has accordingly indicated that co-occurring anxiety and mood disorders are associated with more distress and functional impairment in daily life than either of the disorders alone (e.g., Albert et al, 2008;Brown et al, 1995;Schoevers et al, 2005).…”