Edmonton Obesity Staging System Prevalence and Association with Weight Loss in a Publicly Funded Referral-Based Obesity Clinic

Objectives. To determine the distribution of EOSS stages and differences in weight loss achieved according to EOSS stage, in patients attending a referral-based publically funded multisite weight management clinic. Subjects/Methods. 5,787 obese patients were categorized using EOSS staging using metabolic risk factors, medication use, and severity of doctor diagnosis of obesity-related physiological, functional, and psychological comorbidities from electronic patient files. Results. The prevalence of EOSS stages 0 (no risk factors or comorbidities), 1 (mild conditions), 2 (moderate conditions), and 3 (severe conditions) was 1.7%, 10.4%, 84.0%, and 3.9%, respectively. Prehypertension (63%), hypertension (76%), and knee replacement (33%) were the most common obesity-related comorbidities for stages 1, 2, and 3, respectively. In the models including age, sex, initial BMI, EOSS stage, and treatment time, lower EOSS stage and longer treatment times were independently associated with greater absolute (kg) and percentage of weight loss relative to initial body weight P<0.05. Conclusions. Patients attending this publicly funded, referral-based weight management clinic were more likely to be classified in the higher stages of EOSS. Patients in higher EOSS stages required longer treatment times to achieve similar weight outcomes as those in lower EOSS stages

Individuals underestimate moderate and vigorous intensity physical activity.

BACKGROUND: It is unclear whether the common physical activity (PA) intensity descriptors used in PA guidelines worldwide align with the associated percent heart rate maximum method used for prescribing relative PA intensities consistently between sexes, ethnicities, age categories and across body mass index (BMI) classifications. OBJECTIVES: The objectives of this study were to determine whether individuals properly select light, moderate and vigorous intensity PA using the intensity descriptions in PA guidelines and determine if there are differences in estimation across sex, ethnicity, age and BMI classifications. METHODS: 129 adults were instructed to walk/jog at a "light," "moderate" and "vigorous effort" in a randomized order. The PA intensities were categorized as being below, at or above the following %HRmax ranges of: 50-63% for light, 64-76% for moderate and 77-93% for vigorous effort. RESULTS: On average, people correctly estimated light effort as 51.5±8.3%HRmax but underestimated moderate effort as 58.7±10.7%HRmax and vigorous effort as 69.9±11.9%HRmax. Participants walked at a light intensity (57.4±10.5%HRmax) when asked to walk at a pace that provided health benefits, wherein 52% of participants walked at a light effort pace, 19% walked at a moderate effort and 5% walked at a vigorous effort pace. These results did not differ by sex, ethnicity or BMI class. However, younger adults underestimated moderate and vigorous intensity more so than middle-aged adults (P<0.05). CONCLUSION: When the common PA guideline descriptors were aligned with the associated %HRmax ranges, the majority of participants underestimated the intensity of PA that is needed to obtain health benefits. Thus, new subjective descriptions for moderate and vigorous intensity may be warranted to aid individuals in correctly interpreting PA intensities

Participant Characteristics.

<p>Data are presented as means ± SD, by prevalence (%) or range (minimum-maximum).</p><p>BMI: Body Mass Index.</p><p>CPAG: Canada’s Physical Activity Guide.</p><p>PA: Physical Activity.</p

Measured %HRmax (n = 129) and %HRpeak (n = 35) during Light, Moderate and Vigorous Effort Treadmill exercise.

<p>* Significant difference at P<0.0001. •%HRmax = Observed HR/(220-age) (sub-sample, n = 35). ▴%HRpeak = Observed HR/(HRpeak VO₂ treadmill test) (sub-sample, n = 35). ▪%HRmax = Observed HR/(220-age) (population, n = 129). Cross-hatched boxes = %HRmax range: 50–63% light effort; 64–76% moderate effort; 77–93% vigorous effort.</p