Background/Aims: The Edmonton Obesity Staging System (EOSS) is a tool that helps assess the severity of obesity based on the severity of obesity related complications (0 indicating no complications and 4 indicating end-stage complications). We aimed to determine the EOSS scores of patients attending a publicly funded metabolic program, and whether this score affected metabolic outcomes at 6 months.
Methods: All new patients attending a NSW publicly funded metabolic program from March 2018 with 6-month follow up data before June 2019 were audited.
Results: Of 134 patients, data was available for 112. 97.4% of patients were EOSS≥2, with most either EOSS 2 (55.4%) or EOSS 3 (41.1%). Comparing EOSS≤2 with EOSS≥3, the EOSS≤2 group was significantly younger (47.2±14.9 vs 57.0±9.3years, p<0.001), had fewer men (16.9% vs 40.4%, p=0.01), with no baseline difference in BMI, diabetes prevalence, HbA1c, diabetes medications or systolic BP. A lower proportion of the EOSS≤2 group required insulin at baseline (13.8% vs 31.9%, p=0.02), with a lower prevalence of hypertension (58.5% vs 78.7%, p=0.02), dyslipidaemia (60.0% vs 83.0%, p<0.01) and OSA (40.0% vs 63.8%, p=0.01). There was no significant difference between groups at 6 months in weight loss (4.9±6.1 vs 5.9±7.4kg, p=0.41) or systolic BP reduction (8.9±19.7 vs 15.1±25.2mmHg, p=0.226). HbA1c was significantly reduced in the EOSS≤2 group (7.2±1.8 baseline to 6.7±1.3%, p<0.01) but not in the EOSS≥3 group (7.4±1.7% baseline to 7.15±1.4%, p=0.274). Both groups reduced their total daily insulin dose, with no difference between groups (-88.3±120.1 vs -41.4±60.1 units, p=0.192).
Conclusion: Almost all patients attending our publicly funded metabolic program had a significant burden of obesity related complications, with more men and older patients in the higher EOSS stages. Significant weight loss and blood pressure reduction was achieved regardless of EOSS stage, but improvement in glycaemic control was better attained in the lower EOSS stages.