EDMONTON OBESITY STAGING SYSTEM IMPLEMENTATION AND EFFECTIVENESS IN AN AUSTRALIAN MULTIDISCIPLINARY WEIGHT MANAGEMENT CLINIC OVER A TWO-YEAR PERIOD

Abstract

INTRODUCTION
Multidisciplinary weight management clinics (MWMC) are being established globally to manage the ever-growing obesity epidemic. However, among Australian MWMC, there is a relative paucity of published clinical outcomes, particularly on assessing holistic patient outcomes. The Edmonton Obesity Staging System (EOSS) provides a framework based on metabolic, anthropometric and psychological factors for holistic obesity management, based on a 5-class scale [0-4 (highest-risk class)]. The EOSS has greater health and mortality predictability than traditional BMI or metabolic syndrome measures. To evaluate the implementation and changes in patient outcomes based on an EOSS model in an Australian university hospital-based MWMC.

METHODLOGY
A retrospective review of a cohort of patients (n=76) from the Healthy Weight Clinic, Sydney, over at least 2-year period of regular (<6 monthly) consults. All patients received intervention from at least an endocrinologist, dietitian and exercise physiologist.

RESULTS
Mean baseline EOSS class was 1.56 (SD 0.84) and after 24 months mean EOSS class statistically improved to 1.05 (SD 0.88) (P<0.05). Baseline mean BMI was 38.0 kg/m² (SD 7.1) and mean BMI at last follow-up was 33.4 kg/m² (SD 6.4), also statistically significant (P<0.05). All features of the EOSS scale, namely, anthropometric data, deranged liver function tests, dyslipidaemia and prediabetes state showed clinically significant reductions towards normal levels. Almost three quarters of our patients (72%) dropped reduced at least one EOSS class.

CONCLUSION
Care from MWMC can produce significant reductions in EOSS classes, leading to improved patient outcomes across multiple comorbidities over 2 years. Future studies should compare this framework across Australian MWMC, to establish a standardised approach to biopsychosocial obesity management.