The Edmonton Obesity Staging System Clinical Support Tool: A Structured EOSS-Domain-Based Tool for Primary Care

Although body mass index (BMI) is widely used to diagnose obesity, it is an imprecise measure of health. The Edmonton Obesity Staging System (EOSS) assesses the health impacts of elevated BMI based on medical, mental and functional complications and has been shown to predict mortality more accurately than BMI alone. This study aimed to develop a simple clinical support tool for structured assessment of the EOSS domains in routine clinical practice. An EOSS-based clinical support tool was developed through an iterative Delphi process with obesity-care experts, including pilot testing with patients and general practitioners, a test-retest reliability assessment and a final consensus meeting. The final instrument consists of 48 items across six domains: personal information, medical history, lifestyle, weight-reduction measures, psychosocial burden and functional limitations. Pilot testing indicated good feasibility and clarity, and the test-retest reliability assessment indicated good temporal stability; low-reliability items were revised. This clinical support tool, based on the EOSS domains, is designed to support the structured collection of information on obesity-related medical, functional and psychosocial aspects. Further research is needed to evaluate its validity, feasibility in routine practice and implementation across diverse primary care settings.