DAROC Meet the Professor 1

21 Mar 2026 17:30 18:00

201AF

Yi-Jen HungTaiwan Moderator

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Time	Session

17:30 18:00	Diagnosis and Evaluation of Obesity Hung-Yuan LiTaiwan Speaker Diagnosis and Evaluation of ObesityObesity is now widely recognized as a chronic, heterogeneous disease rather than a simple consequence of excess body weight. Contemporary perspectives emphasize that obesity-related health risk arises not only from the quantity of adipose tissue, but also from its distribution and functional status. In recent years, major international organizations—including the The Lancet Commission on Obesity, the American Association of Clinical Endocrinology (AACE), the European Association for the Study of Obesity (EASO), the Japan Society for the Study of Obesity (JASSO), and the American Diabetes Association (ADA)—have proposed evolving frameworks for obesity diagnosis that move beyond reliance on body mass index (BMI) alone. This session will review current concepts in the diagnosis and evaluation of obesity, integrating anthropometric measures, adiposity distribution, obesity-related complications, and functional consequences of excess fat. While BMI remains a practical and widely used screening tool, its limitations at the individual level are increasingly recognized. Complementary measures such as waist circumference and waist-to-height ratio provide important additional information, particularly for assessing central adiposity and cardiometabolic risk in Asian populations. A central theme of this lecture is the concept of obesity-related complications and diseases (ORCD), which can be broadly categorized into two interrelated entities. Fat mass disease refers to conditions driven predominantly by excessive fat mass and its mechanical or quantitative burden, whereas sick fat disease reflects adipose tissue dysfunction characterized by abnormal endocrine, inflammatory, and metabolic signaling. Both entities contribute to ORCD, either independently or in combination, and together account for the heterogeneous clinical manifestations of obesity. According to the definitions proposed by the Lancet Commission on Obesity, obesity can be conceptualized along a continuum from preclinical obesity to clinical obesity. Preclinical obesity is characterized by excess adiposity without established ORCD and corresponds conceptually to AACE stage 1, representing a key opportunity for primary prevention. In contrast, clinical obesity is defined by the presence of ORCD and aligns with AACE stage 2 and stage 3, in which clinical management focuses on secondary prevention, risk reduction, and complication management. This integration of Lancet Commission concepts with AACE staging provides a disease-oriented framework for risk stratification and therapeutic decision-making. Comprehensive obesity evaluation must also address psychological, behavioral, and socio-cultural factors. Mental health conditions such as binge-eating disorder, depression, and anxiety may both contribute to and result from obesity, forming bidirectional relationships that influence disease trajectory. In addition, weight stigma, health literacy, and environmental and cultural contexts significantly affect treatment acceptance, adherence, and long-term outcomes, and should be incorporated into routine clinical assessment. In conclusion, this session will propose a pragmatic, stepwise approach to obesity diagnosis and evaluation that integrates ORCD phenotyping with AACE stage 1–3 classification and the conceptual framework of the Lancet Commission. This approach is intended not only to inform clinical decision-making, but also to serve as the foundation for the forthcoming obesity-related clinical practice guidelines of the Diabetes Association of the Republic of China, bridging global concepts with local implementation.

Time

Session

17:30

18:00

Diagnosis and Evaluation of Obesity

Hung-Yuan LiTaiwan Speaker Diagnosis and Evaluation of ObesityObesity is now widely recognized as a chronic, heterogeneous disease rather than a simple consequence of excess body weight. Contemporary perspectives emphasize that obesity-related health risk arises not only from the quantity of adipose tissue, but also from its distribution and functional status. In recent years, major international organizations—including the The Lancet Commission on Obesity, the American Association of Clinical Endocrinology (AACE), the European Association for the Study of Obesity (EASO), the Japan Society for the Study of Obesity (JASSO), and the American Diabetes Association (ADA)—have proposed evolving frameworks for obesity diagnosis that move beyond reliance on body mass index (BMI) alone. This session will review current concepts in the diagnosis and evaluation of obesity, integrating anthropometric measures, adiposity distribution, obesity-related complications, and functional consequences of excess fat. While BMI remains a practical and widely used screening tool, its limitations at the individual level are increasingly recognized. Complementary measures such as waist circumference and waist-to-height ratio provide important additional information, particularly for assessing central adiposity and cardiometabolic risk in Asian populations. A central theme of this lecture is the concept of obesity-related complications and diseases (ORCD), which can be broadly categorized into two interrelated entities. Fat mass disease refers to conditions driven predominantly by excessive fat mass and its mechanical or quantitative burden, whereas sick fat disease reflects adipose tissue dysfunction characterized by abnormal endocrine, inflammatory, and metabolic signaling. Both entities contribute to ORCD, either independently or in combination, and together account for the heterogeneous clinical manifestations of obesity. According to the definitions proposed by the Lancet Commission on Obesity, obesity can be conceptualized along a continuum from preclinical obesity to clinical obesity. Preclinical obesity is characterized by excess adiposity without established ORCD and corresponds conceptually to AACE stage 1, representing a key opportunity for primary prevention. In contrast, clinical obesity is defined by the presence of ORCD and aligns with AACE stage 2 and stage 3, in which clinical management focuses on secondary prevention, risk reduction, and complication management. This integration of Lancet Commission concepts with AACE staging provides a disease-oriented framework for risk stratification and therapeutic decision-making. Comprehensive obesity evaluation must also address psychological, behavioral, and socio-cultural factors. Mental health conditions such as binge-eating disorder, depression, and anxiety may both contribute to and result from obesity, forming bidirectional relationships that influence disease trajectory. In addition, weight stigma, health literacy, and environmental and cultural contexts significantly affect treatment acceptance, adherence, and long-term outcomes, and should be incorporated into routine clinical assessment. In conclusion, this session will propose a pragmatic, stepwise approach to obesity diagnosis and evaluation that integrates ORCD phenotyping with AACE stage 1–3 classification and the conceptual framework of the Lancet Commission. This approach is intended not only to inform clinical decision-making, but also to serve as the foundation for the forthcoming obesity-related clinical practice guidelines of the Diabetes Association of the Republic of China, bridging global concepts with local implementation.