The parameters that experts use to determine whether a person is obese are:
Determination of Body Mass Index (BMI)
Determining the percentage of body fat.
They are indirect measures that attempt to provide information about body fat and its regional distribution.
However, as he believes Dr. Diego Bellido GuerreroHead of the Endocrinology and Nutrition Service of the Ferrol University Hospital Complex
“Many times the value of these measurements does not represent the percentage of total body fat or its distribution.”
For this reason, this expert claims that a “radical change in the assessment of patients with obesity” is needed.
Evaluate by biopsy of adipose tissue
At this point, it appears that comprehensively evaluating adipose tissue via biopsy may hold the key to optimizing the management of obesity: a disease characterized by excessive adiposity.
These new approaches also attempt to tackle the problem of the existence of different types of “obesity”, meaning that people with the same BMI or body fat may have a different cardiometabolic risk.
because as a sentence Dr. Clotilde Vazquez MartinezHead of the Department of Endocrinology and Nutrition of the Jiménez Díaz-Quironsalud Foundation:
“We can’t continue to treat everyone who has a disease as complex and heterogeneous as obesity is in the same way.”
“Precision Medicine Is Coming”
“If the diseased tissue is thick, why not take a sample, a biopsy, and study it?” asks Dr. Albert LecubeVice President of the Spanish Obesity Society (SEEDO), giving the example of breast cancer.
In this oncological disease, according to the expert, “the biopsy allows us to differentiate between the different types of tumors and the treatment. Well, the same way of thinking is what we should bring to obesity: knowing the histological characteristics of each patient.” and taking precise medicine”.
and that, as Dr. Amaia Rodriguez Murueta-GoynaFrom the Metabolic Research Laboratory of the University of Navarra Clinic:
“The study of genetic, morphological and functional changes in biopsy of subcutaneous adipose tissue (SAT) constitutes a useful tool for personalized medicine, as it allows better diagnosis and management of overweight or obese patients” .
How is it done and what is its contribution?
Adipose tissue biopsy is obtained during the surgical procedure and allows the multidisciplinary team in charge of patient management to obtain very detailed information on genetic alterations and the degree of adipose tissue dysfunction.
All of this may help predict weight loss and improved metabolism after surgery.
Of course, this type of intervention “should always be performed in a clinical setting and with the informed consent of the patient, being especially recommended in severe obesity,” explains Dr. Rodriguez.
With this type of intervention, it is also possible to “know the degree of adipose tissue dysfunction and to identify individuals at high cardiometabolic risk”.
Last but not least, another utility that is on TAS biopsy Part of the existence of an association between obesity and various types of cancer (such as breast cancer, colorectal or prostate cancer in post-menopausal women).
“The study of adipose tissue surrounding tumors is an emerging tool to understand the molecular mechanisms involved in the development and progression of this type of obesity-associated cancer,” says Rodríguez Murueta-Goyna.
Fat Distribution: Another Major Factor
Until recently, fat was recognized only for basic functions, for storing energy or protecting internal organs.
But now, it is known that adipose tissue acts as an endocrine organ capable of secreting hormones, cytokines, growth factors, vasoactive substances that participate in the regulation of various biological processes such as body weight regulation , formation of new blood vessels, reproduction or immunity, among others.
Therefore, in addition to determining its quantity, it is also necessary to thoroughly assess and identify the distribution of body fat. Doctor. “If the amount of fat is important, then knowing its location and the degree of activity of adipose tissue is no less important,” says Lecube.
Thus, depending on where the fat is located, the likelihood of developing various pathologies associated with obesity will be higher.
For example, visceral obesityAbdominal fat accumulation is characterized by the presence of a greater number of metabolic alterations and cardiovascular risk, which is not the case when there is excess fat in the gluteal-femoral region.
another example is sarcopenic obesity, characterized by a loss of muscle mass (sarcopenia) that is accompanied by excess body fat (particularly in the visceral region). This type of obesity is a risk factor for frailty, functional decline and increased mortality, so its proper diagnosis is highly recommended.