Justification of the need to create a new classification of obesity

The results of numerous studies conducted over the past decades have shown that the greatest importance in determining the risk of disease and death at the individual level is the accumulation of visceral adipose tissue, associated with the development of metabolic disorders and local influence when it accumulates in the internal organs. Bioimpedance analysis is a simple and widely available clinical method for determining the excess content of visceral adipose tissue, thereby allowing you to identify patients with obesity and a high risk of developing cardiovascular complications, even in the first meeting with a doctor. The results of the determination of visceral adipose tissue by bioimpedance analysis are comparable with the data obtained by CT and MRI. According to our observations conducted on 154 patients with various cardiovascular diseases, the content of visceral adipose tissue , which is 14% or more according to bioimpedance analysis, was combined with disorders characteristic of the metabolic syndrome. At the same time, the increase in BMI from the 1st to the 3rd degree did not reflect the severity of metabolic disorders. There were no significant differences in the content of visceral adipose tissue and blood levels of triglycerides, glucose, and HDL-C in patients with different degrees of obesity. To date, it is obvious that obesity, determined by BMI, is very heterogeneous and its negative role in the development of diseases is revealed only when observing very large groups of the population. Research data on the importance of visceral adipose tissue and its association with risk factors for cardiovascular disease suggest the need for a new classification of obesity. We present a draft for discussing the new classification of obesity in our article.