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Review
. 2025 Aug;55(8):e70059.
doi: 10.1111/eci.70059. Epub 2025 May 15.

Bridging the gap in obesity research: A consensus statement from the European Society for Clinical Investigation

Federico Carbone  1   2 , Jean-Pierre Després  3   4 , John P A Ioannidis  5   6   7 , Ian J Neeland  8   9 , Gabriella Garruti  10 , Luca Busetto  11 , Luca Liberale  1   2 , Stefano Ministrini  12   13 , Gemma Vilahur  14   15 , Thomas H Schindler  16 , Maria Paula Macedo  17   18 , Agostino Di Ciaula  10 , Marcin Krawczyk  19   20 , Andreas Geier  21   22 , Gyorgy Baffy  23 , Maria Felicia Faienza  10 , Ilaria Farella  24 , Nicola Santoro  25   26 , Gema Frühbeck  27   28   29 , Patricia Yárnoz-Esquiroz  27   28   29 , Javier Gómez-Ambrosi  27   28   29 , Emma Chávez-Manzanera  30 , Verónica Vázquez-Velázquez  30 , Jean-Michel Oppert  31 , Dimitrios N Kiortsis  32 , Paolo Sbraccia  33 , Carmine Zoccali  34   35   36 , Piero Portincasa  10 , Fabrizio Montecucco  1   2
Affiliations
Review

Bridging the gap in obesity research: A consensus statement from the European Society for Clinical Investigation

Federico Carbone et al. Eur J Clin Invest. 2025 Aug.

Abstract

Background: Most forms of obesity are associated with chronic diseases that remain a global public health challenge.

Aims: Despite significant advancements in understanding its pathophysiology, effective management of obesity is hindered by the persistence of knowledge gaps in epidemiology, phenotypic heterogeneity and policy implementation.

Materials and methods: This consensus statement by the European Society for Clinical Investigation identifies eight critical areas requiring urgent attention. Key gaps include insufficient long-term data on obesity trends, the inadequacy of body mass index (BMI) as a sole diagnostic measure, and insufficient recognition of phenotypic diversity in obesity-related cardiometabolic risks. Moreover, the socio-economic drivers of obesity and its transition across phenotypes remain poorly understood.

Results: The syndemic nature of obesity, exacerbated by globalization and environmental changes, necessitates a holistic approach integrating global frameworks and community-level interventions. This statement advocates for leveraging emerging technologies, such as artificial intelligence, to refine predictive models and address phenotypic variability. It underscores the importance of collaborative efforts among scientists, policymakers, and stakeholders to create tailored interventions and enduring policies.

Discussion: The consensus highlights the need for harmonizing anthropometric and biochemical markers, fostering inclusive public health narratives and combating stigma associated with obesity. By addressing these gaps, this initiative aims to advance research, improve prevention strategies and optimize care delivery for people living with obesity.

Conclusion: This collaborative effort marks a decisive step towards mitigating the obesity epidemic and its profound impact on global health systems. Ultimately, obesity should be considered as being largely the consequence of a socio-economic model not compatible with optimal human health.

Keywords: body mass index; cardiovascular risk; management of obesity; metabolic dysfunction‐associated steatotic liver disease; metabolically healthy obesity; obesities; obesity; obesity definition; obesity transition; paediatric obesity; waist circumference.

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Conflict of interest statement

Ian J Neeland received consulting fees/speaker fees from Boehringer Ingelheim, Eli Lilly, Novo Nordisk and Bayer. Luca Busetto received payment of honoraria from Lilly, Novo Nordisk, Boehringer Ingheleim, Pfizer and Regeneron as a member of advisory boards, and payment of honoraria for lectures from Rhytms Pharmaceuticals. Luca Liberale is co‐inventor on the international patent WO/2020/226993 filed in April 2020. The patent relates to the use of antibodies which specifically bind IL‐1α to reduce various sequelae of ischaemia–reperfusion injury to the central nervous system. Luca Liberale reports speaker fees from Daiichi‐Sankyo outside the submitted work and has received funding from the Novartis Foundation for Medical‐biological Research (unrelated to this work). Gema Frühbeck received payment of honoraria from Lilly, Novo Nordisk, Regeneron and AstraZeneca as a member of advisory boards, and payment of honoraria for lectures as member of the OPEN Spain Initiative. Verónica Vázquez Velázquez has an unpaid position of Chair of the non‐profit organization Obesidades Mexico, declares honoraria for expert advice on educational projects and campaigns related to obesity from Novo Nordisk and Ely Lilly, honoraria and travel support for lectures, presentations in conferences and educational events from Novo Nordisk, Eli Lilly, Merck and Boehringer Ingelheim, support for attending academic events from Novo Nordisk and World Obesity Federation, support for participation on advisory boards from Novo Nordisk, Eli Lilly and Boehringer Ingelheim, and grants for Obesidades for carrying out an awareness campaign, for a research project and for social activities from Novo Nordisk. Paolo Sbraccia received payment of honoraria from Lilly, Novo Nordisk, Boehringer Ingheleim, Pfizer, Amryt (Chiesi) as a member of advisory boards and payment of honoraria for lectures from Lilly, Novo Nordisk, Amryt (Chiesi). Emma Chávez Manzanera reports honoraria for lectures, presentations and educational events from Novo Nordisk, Merck, Boehringer Ingelheim and Silanes; advisory board honoraria from Abbott, Eli Lilly and Merck. Andreas Geier reports support from the IMI2 LITMUS project; research grants from Novartis, Falk and Intercept; consulting or speakers fees from Abbvie, Advanz, Albireo, Alexion, AstraZeneca, Bayer, BMS, Boehringer, Burgerstein, CSL Behring, Eisai, Falk, Gilead, Heel, Intercept, Ipsen, Merz, MSD, Novartis, NovoNordisk, Orphalan, Pfizer, Roche, Sanofi‐Aventis.; and travel/meeting supports from Intercept, Gilead, Abbvie and Falk. The other authors declared no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Summary of contemporary methods for obesity assessment/phenotyping. Based on anthropometric and biochemical parameters there are a plethora of proposed criteria for obesity assessment and phenotyping. BMI, body mass index; BRI, body roundness index; BSA, body surface area; BSI, body shape index; CMI, cardiometabolic index; CUN‐BAE, Clínica Universidad de Navarra‐Body Adiposity Estimator; LAP, lipid accumulation product; METS‐IR, metabolic score for insulin resistance; METS‐VF, metabolic score for visceral fat; RFM, relative fat mass; TyG, triglyceride‐glucose index; VAI, visceral adiposity index; WHR, waist circumference‐to‐hip circumference ratio; WHtR, waist circumference‐to height ratio; WWI, weight‐adjusted waist index. Created by Biorender.com.
FIGURE 2
FIGURE 2
Types of adipose tissue and their main functions and impact on cardiovascular risk. Created by Biorender.com.
FIGURE 3
FIGURE 3
The novel criteria for the diagnosis of metabolic dysfunction‐associated steatotic liver disease (MASLD). The presence of liver steatosis by imaging and the presence of at least one cardio‐metabolic abnormality among five is required. Once the diagnosis of MASLD has been established, the potential progression of disease includes metabolic dysfunction‐associated steatohepatitis (MASH) without and with fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The continuous role of genetic factors, comorbidities, and other environmental factors is also depicted in the appropriate box. This cartoon depicts several close interactions between the condition of liver steatosis and the development of chronic non‐communicable diseases and vice versa. Created by Biorender.com.
FIGURE 4
FIGURE 4
A proportion of participants achieving 10% or more total body weight loss after 1 year with currently available therapeutic approaches (based on data reviewed in Perdomo et al. 567 ).
FIGURE 5
FIGURE 5
Overview of the elements that can influence and shape the care of people living with obesity (PlwO).
FIGURE 6
FIGURE 6
Schematic representation on how a holistic approach based on detailed phenotyping will improve an individualized diagnosis and treatments in the future of obesity management that need to translate into better prevention strategies and policy indications.
See this image and copyright information in PMC

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