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Ep. 50 | Navigating the Complexity of Redefining Obesity Care

in-the-know-with-nina

podcast

Episode Summary

In this milestone 50th episode, Dr. Nina Crowley is joined by Dr. Marc-André Cornier—President of The Obesity Society—to unpack the complexities of diagnosing and treating obesity in 2025. The conversation centers around the Lancet Commission Report and its proposal to redefine obesity with new classifications like “clinical” and “preclinical” obesity. Dr. Cornier discusses the challenges of moving beyond BMI, the implications for insurance and early treatment, and why a comprehensive, chronic care model is essential. They also explore the risks of compounded obesity medications and the importance of elevating body composition analysis in routine care.

Key Takeaways

Redefining Obesity: The Lancet Commission's “clinical vs. preclinical” categories could hinder early access to care, especially in pediatrics.
Body Composition Over BMI: While BMI has value at a population level, it’s insufficient for personalized diagnosis. Waist circumference and BIA are underutilized tools.
Treatment Access: There are no current ICD codes for “clinical” or “preclinical” obesity, making practical implementation premature.
Medication Caution: The Obesity Society opposes compounded GLP-1 medications due to lack of regulation, safety concerns, and payer disincentives.
Chronic Care Model: Obesity requires long-term, multidisciplinary management—not just short-term prescriptions.
Public Education: Misinformation about obesity is rampant, despite increased awareness. Professional organizations must lead education efforts.
ObesityWeek 2025: A platform for further debate on obesity reclassification, body comp adoption, and emerging treatments.

About Marc-André Cornier, MD, FTOS

Marc-André Cornier, MD, FTOS is a Professor of Medicine and Director of the Division of Endocrinology, Diabetes and Metabolic Diseases at the Medical University of South Carolina (MUSC). Previously, he served as Medical Director at the Anschutz Health and Wellness Center in Colorado. Dr. Cornier has over 18 years of continuous funding from NIH, ADA, and the VA, studying the regulation of food intake, body weight, and metabolism. He is also an active clinician and mentor. In 2025, he serves as President of The Obesity Society.