Redefining obesity: a diagnostic opportunity with clinical and structural challenges

Abstract

In January 2025, The Lancet Diabetes & Endocrinology Commission published a paper that redefines clinical obesity as a chronic, systemic disease, characterized not only by excess adiposity, but also by its functional consequences on organs, tissues and people’s daily lives. It also introduces the concept of preclinical obesity, defined as a state of excess adiposity with preserved organ and tissue function, but with an increased - albeit variable - risk of developing clinical obesity and other non-communicable diseases such as type 2 diabetes, cardiovascular disease, certain cancers and mental disorders. This proposal therefore introduces a new diagnostic category that distinguishes between preclinical and clinical obesity, which has generated broad debate across scientific, clinical, and public health domains.
The Obesity Study Group of the Asociación Argentina de Licenciados en Nutrición (AALEN) analyzed the aforementioned redefinition, considering its scientific rationale, its applicability in professional practice and its possible impact in the Argentine context. While acknowledging the significant progress in addressing biometric reductionism and reducing the stigma associated with the diagnosis, the group also identified concrete challenges related to clinical feasibility and equity in access to diagnosis and treatment.