Clinical use of the Edmonton obesity staging system for the assessment of weight management outcomes in people with class 3 obesity

Raymond Kodsi, Ritesh Chimoriya, David Medveczky, Kathy Grudzinskas, Evan Atlantis, Abd A Tahrani, Nic Kormas, Milan K Piya

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We aimed to assess weight loss and metabolic outcomes by severity of weight-related complications following an intensive non-surgical weight management program (WMP) in an Australian public hospital. A retrospective cohort study of all patients aged ≥18 years with body mass index (BMI) ≥ 40 enrolled in the WMP during March 2018-March 2019 with 12-month follow-up information were stratified using the Edmonton Obesity Staging System (EOSS). Of 178 patients enrolled in the WMP, 112 (62.9%) completed at least 12 months' treatment. Most patients (96.6%) met EOSS-2 (56.7%) or EOSS-3 (39.9%) criteria for analysis. Both groups lost significant weight from baseline to 12 months; EOSS-2: 139.4 ± 31.8 kg vs. 131.8 ± 31.8 kg (p < 0.001) and EOSS-3: 141.4 ± 24.2 kg vs. 129.8 ± 24.3 kg (p < 0.001). After adjusting for baseline age, sex and employment status, mean weight loss was similar but a greater proportion of EOSS-3 achieved >10% weight loss compared to EOSS-2, (40% vs. 15.9%, p = 0.024). Changes in metabolic parameters including HbA1c, BP and lipids did not differ between EOSS-2 and 3. Despite increased clinical severity, adult patients with class 3 obesity achieved clinically meaningful weight loss and similar improvements in metabolic parameters compared to patients with less severe complications after 12 months in an intensive non-surgical WMP.

Original languageEnglish
Article number967
Number of pages12
Issue number5
Publication statusPublished - 24 Feb 2022

Bibliographical note

Funding Information:
Conflicts of Interest: The authors have no conflict of interest to declare, apart from below. Tahrani (A.A.T.) reports the following outside the submitted work: grants from Novo Nordisk and Sanofi; personal fees from Novo Nordisk, Janssen, AZ, Eli Lilly, BI, BMS, NAPP, MSD, Nestle, Gilead, Sanofi as well as non-financial support from Novo Nordisk, Eli Lilly, AZ, Impeto medical, Resmed, Aptiva, BI, BMS, NAPP, MSD, A.A.T. is currently an employee of Novo Nordisk but this work was performed before he became a Novo Nordisk employee. Novo Nordisk had no role in this study. E.A. was the Founding President, and now serves as the Secretary, of National Association of Clinical Obesity Services (NACOS), Australia. He has received honoraria from Novo Nordisk for speaking and participating at meetings. He has received unrestricted research funding from Novo Nordisk and iNova on behalf of NACOS. M.K.P. is a Guest Editor on the Special Issue “Weight Management Interventions: Predictors and Outcomes” of Nutrients journal but did not play any role in the peer-review or decision-making process for this manuscript.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • Adolescent
  • Adult
  • Australia
  • Body Mass Index
  • Humans
  • Obesity/surgery
  • Retrospective Studies
  • Weight Loss
  • Weight management
  • Obesity staging
  • Class 3 obesity

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics


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