Edmonton Obesity Staging System: Redefining How We Judge Childhood Obesity

Dr Mudita Dhingra, Consultant Diabetologist, Shree Guru Kripa Endocrine Clinic, Kurukshetra

In Mexican children with obesity, most were classified as severe (EOSS-P stage 3), showing that meaningful health risks often extend beyond BMI and require a multidimensional clinical assessment.

A study published in Children strengthens the case for the Edmonton Obesity Staging System for Pediatrics (EOSS-P) as a more meaningful lens to understand childhood obesity than BMI alone. Conducted at a tertiary pediatric obesity clinic in Mexico City, the research reveals that most children living with obesity were classified as EOSS-P stage 3—indicating significant medical, mechanical, or psychosocial complications—while none were placed in the “healthier” stage 0. This challenges the comforting but misleading notion that weight category alone reflects health status.

Using Bayesian statistical modelling, investigators showed that children with class II–III obesity were more likely to have problems in metabolic, mechanical, and social domains. Yet the study’s deeper message is not statistical—it is conceptual. Two children with the same BMI can live entirely different realities: one active and metabolically stable, another struggling with insulin resistance, joint pain, stigma, or school absenteeism. EOSS-P captures this lived experience.

For a country like Mexico, where nearly one in five children has obesity and the economic burden is enormous, staging systems matter. They can guide clinicians toward individualized care, prioritize high-risk patients, and shift public discourse from blame to biology, behaviour, and environment.

The EOSS-P reframes obesity not as a weight problem, but as a health condition that demands holistic assessment, compassionate care, and smarter policy responses.

(Source: Omaña-Guzmán I, Rodríguez Quintero RC, Ruíz-Arroyo A, Prado Díaz E, López-Alvarenga JC, Hernández López AM, Fuentes Corona Z, Aguilar Cuarto K, Pedraza Escudero K, Ruíz Barranco A, Villanueva-Ortega E. The Edmonton Obesity Staging System for Pediatrics (EOSS-P) in Mexican Children and Adolescents Living with Obesity: Beyond BMI Obesity Classes. Children. 2025 Nov 17;12(11):1556. )