Assessment of XXXX beyond body mass index to determine benefit of treatment.

@entity1 @entity353 @entity6 @entity28 @entity444 @entity65
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT:        Weight or @entity353 per se may not indicate health status or health benefit.        There is no gold standard for assessing which @entity1 would benefit most from weight-loss interventions.        The King's Criteria is one of several recently proposed @entity28 classification systems. WHAT THIS STUDY ADDS:        The King's Criteria can capture health problems related to @entity28 and health benefits after @entity353 .        The King's Criteria is a reproducible scoring system.        Using the King's Criteria may help shift the focus of @entity1 and clinicians from @entity353 to health gain. SUMMARY: Body mass index (BMI) alone does not reflect health status in individuals. The King's Obesity Staging Criteria is a clinical tool for the assessment of @entity1 with complex @entity28 . We assessed the performance of a modified version of the King's Criteria by scoring 144 @entity28 @entity1 before and 1 year after bariatric surgery. We also evaluated inter-observer variability by having 11 clinicians score the same 12 @entity1 . The King's Obesity Staging Criteria comprise nine health domains: Airways, Body mass index, @entity65 , @entity6 , Economic complications, Functional limitations, @entity444 , Health status (perceived), and body Image. For each domain, a @entity1 's health is assigned a score of 0 ('normal health'), 1 ('at risk'), 2 ('established disease') or 3 ('advanced disease'). The @entity1 's mean BMI decreased from 48        7 to 37        7   kg   m(-2) post surgery. Before surgery, 84% of @entity1 were either in stage 2 ('established disease') or stage 3 ('advanced disease') for one or more domains other than BMI. The modified King's Criteria showed significant health improvements after surgery, with a higher proportion of @entity1 scored in stage 0 ('normal health') within each health domain (P   <   0.001 for all). Observers assigned the same score in >75% of cases for all domains except Health status perceived (71%) and body Image (65%). In conclusion the King's Criteria captured morbidity in @entity28 @entity1 and health gains after @entity353 . Different clinicians mostly assigned similar scores. The King's Criteria is a clinical tool that may help shift the focus of @entity1 and clinicians towards improving health and not only losing weight. REGISTRATION NUMBER: NCT01112228 (http://www.clinicaltrials.gov).
