Emerging and current trend in the investigation of obesity in clinical practice

Obesity is a medical condition in which excess body fat has accumulated to the extent that it could produce a negative adverse health effect. The various emerging and current investigational methods or techniques for the analysis and determination of total body fat composition and body fat percentage are the theoretical gold standard method of underwater weighing which has its foundation on Archimedes' principle, Bioelectrical Impedance Analysis (BIA), Whole-body Air Displacement Plethysmography (ADP), Dual-Energy X-ray Absorptiometry (DEXA), Near Infrared interactance (NIR), Body Average Density (BAD) Measurement, Ultrasound Sonography Technique (UST) and Anthropometric Measurements (AM) such as triceps skinfold thickness (TSF), Mid-upper arm circumference (MAC), Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Stature ratio (WSR or WHtR), Waist-to-thigh ratio (WTR) and/or Obesity Determinant Indices (ODI). We the authors of this research work currently propose and recommend the Obesity Determinant Indices (ODI) as novel anthropometric measurements that will serve as a more reliable predictor and accurate indicator of cardiovascular disease risk factors, including body fat redistribution, hypertension, dyslipidemia, stroke, ischemic heart diseases, heart failure, chronic kidney disease, sleep apnea and type 2 diabetes mellitus in obese patients. Furthermore, We also jointly propose and recommend the diagnostic and interventional criteria for obesity treatment which are the First Criteria (Criteria-I) and Second Criteria (Criteria-II). These criteria take into consideration the presence of an individual body mass index (BMI), presence of at least one waist circumference (WC) dependent parameters (such as WC or WHR or WHtR or WTR or any of the ODI) that fall into the obesity reference range, and/or presence of at least one obesity-related comorbid conditions/risk factors such as hypertension, type 2 diabetes mellitus, dyslipidemia, osteoarthritis, rheumatoid arthritis, polycystic ovarian syndrome, heart failure, ischemic heart diseases, sleep apnea, depression disorders, anorexia nervosa, bulimia nervosa or any other obesity-associated neuropsychiatric disorders. In conclusion, initiation of appropriate treatment in the form of High-Intensity Lifestyle Interventions alone or a combination of pharmacotherapy with Low-to-Moderate-Intensity Lifestyle Interventions should be commenced for any patient that meet these stipulated criteria guidelines.