P030 Implementing the Edmonton Obesity Staging System: a cross-sectional study of the prevalence and management of obesity in a systemic therapies clinic
Bibliographic record
Abstract
Abstract Registry studies from the UK and Ireland report the incidence of obesity among patients on systemic treatment for psoriasis as 40%. This is almost double the background population prevalence of obesity in the UK (26%) and Ireland (23%). Patients with higher body mass index (BMI) have poorer responses to systemic therapies. This study aimed to investigate the prevalence and management of obesity among consecutive patients attending dermatology systemic clinics. Weight and height were recorded, and a patient questionnaire was distributed. Patients identified as living with obesity were classified using the Edmonton Obesity Staging System (EOSS). The EOSS categorizes patients living with obesity into five stages based not solely on BMI but on the presence of obesity-related comorbidities; studies have shown the staging system correlates with clinical outcomes. The study included 113 participants. The median age was 49 years (range 19–79), and 57% (64) of participants were female. The most common diagnosis was psoriasis (77%, 88), followed by atopic dermatitis (16%, 19) and hidradenitis suppurativa (HS) (0.4%, five). Defining a BMI of ≥ 25 kg m−2 as overweight and ≥ 30 kg m−2 as obese, 38% (43) of patients were overweight and 45% (51) were living with obesity. The mean BMI was 31.4 kg m−2, with an SD of 7.3 (range 19.4–53.5). The mean BMI in patients with psoriasis was 31 kg m−2, with eczema 28 kg m−2 and HS 41 kg m−2. Of those living with obesity, 31% (16) fulfilled the requirements for EOSS stage 3, and 32% (37) met the criteria for EOSS stage 2. Hypertension at 31% (36) and mental health issues related to weight at 33% (38) were the two most common self-reported comorbidities. In total, 23% (26) of patients were being prescribed a biologic agent at an increased dose or frequency, and 92% (24) of these patients were either overweight or obese, reflecting the challenges of treating this patient cohort. Overall, 80% (41) of patients in the study classified as living with obesity expressed an interest in accessing medical management for their obesity, while 10% (n = 9) reported that a doctor had discussed obesity management options with them. This is the first study to implement an obesity staging system to examine patients with dermatological diagnoses. The results show that our patients on systemic therapies do not simply have high BMIs but also have physical and psychological consequences. New medical options for the management of obesity have the potential to help many of our patients and, in turn, improve their coexisting dermatological diseases. The EOSS is a valuable tool in time-poor environments to assess obesity and facilitate discussion of management options.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".