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Development of a core patient-centred outcome set for adults living with obesity : a modified delphi-based international consensus

Mekonnen, Teferi ; Staniford, Leanne ; Connell, Spencer ; Das-Gupta, Zofia ; DeSilva, Umanga ; Saoud, Yasmine ; Miller, Isabel ; Mohan, Mohapradeep ; Nienhuijs, Simon and Poddar, Megha , et al. (2025) In EClinicalMedicine 87.
Abstract

Background: Obesity is a chronic disease linked to over 200 health conditions, reduced quality of life, and increased mortality. Despite the availability of multimodal treatments, there is a lack of standardised, patient-centred outcome measures to effectively assess and improve clinical care. This project aimed to define a core set of standardised outcome measures for adults with obesity, incorporating both patient-reported and clinician-reported outcomes. Additional objectives included determining the optimal measurement frequency and identifying case-mix variables essential for risk adjustment. Methods: The International Consortium for Health Outcomes Measurement (ICHOM) established the Obesity Working Group (OWG), composed of 29... (More)

Background: Obesity is a chronic disease linked to over 200 health conditions, reduced quality of life, and increased mortality. Despite the availability of multimodal treatments, there is a lack of standardised, patient-centred outcome measures to effectively assess and improve clinical care. This project aimed to define a core set of standardised outcome measures for adults with obesity, incorporating both patient-reported and clinician-reported outcomes. Additional objectives included determining the optimal measurement frequency and identifying case-mix variables essential for risk adjustment. Methods: The International Consortium for Health Outcomes Measurement (ICHOM) established the Obesity Working Group (OWG), composed of 29 international experts and individuals living with obesity. Members were selected based on their expertise in obesity care and research and represented 21 countries. The development process, conducted from May 2023 to July 2024, began with a kick-off meeting to define scope, followed by eight virtual meetings. A comprehensive literature review informed the identification of relevant clinical outcomes, patient-reported outcomes, treatment-related complications, and case-mix variables. A three-round Delphi process was used to reach consensus on key outcomes and follow-up intervals. Outcomes were included in the final set if at least 80% of OWG members rated them between 7 and 9 on a 9-point scale. Validation was conducted through surveys with 95 patients and 106 healthcare professionals from fields such as dietetics, obesity medicine, and general practice. Findings: The OWG developed a standardised set of 20 outcome measures, comprising 17 core measures and 3 population-specific measures. These span domains including physical health, psychosocial well-being, health behaviours, body functioning, and adverse events. Specific measures were also developed for bariatric surgery and female reproductive health (both pregnant and non-pregnant individuals). Key case-mix factors and appropriate follow-up periods were defined to support global consistency in reporting. Interpretation: Adoption of this standardised outcome set enables clinicians, patients, and stakeholders to identify care gaps, monitor outcomes, and evaluate the quality of obesity care against global benchmarks. Implementation can support the creation of a robust international data resource to guide research, inform clinical practice, and shape policy and guidelines for adult obesity treatment. Limitations include limited geographical diversity in validation surveys, the exclusion of internalised weight bias due to a lack of validated measurement tools, and limited applicability to individuals with obesity and multiple comorbidities. Funding: Novo Nordisk, Eli Lilly, and Boehringer Ingelheim International GmbH.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult obesity, Clinical practice, ICHOM, Outcome measures, Patient-centred outcomes
in
EClinicalMedicine
volume
87
article number
103422
publisher
Lancet Publishing Group
external identifiers
  • scopus:105013653565
  • pmid:40896463
ISSN
2589-5370
DOI
10.1016/j.eclinm.2025.103422
language
English
LU publication?
no
additional info
Publisher Copyright: © 2025 The Author(s)
id
a4942217-ae7a-46de-a05f-3d44f5e6c2cb
date added to LUP
2026-02-18 12:47:43
date last changed
2026-02-19 10:49:22
@article{a4942217-ae7a-46de-a05f-3d44f5e6c2cb,
  abstract     = {{<p>Background: Obesity is a chronic disease linked to over 200 health conditions, reduced quality of life, and increased mortality. Despite the availability of multimodal treatments, there is a lack of standardised, patient-centred outcome measures to effectively assess and improve clinical care. This project aimed to define a core set of standardised outcome measures for adults with obesity, incorporating both patient-reported and clinician-reported outcomes. Additional objectives included determining the optimal measurement frequency and identifying case-mix variables essential for risk adjustment. Methods: The International Consortium for Health Outcomes Measurement (ICHOM) established the Obesity Working Group (OWG), composed of 29 international experts and individuals living with obesity. Members were selected based on their expertise in obesity care and research and represented 21 countries. The development process, conducted from May 2023 to July 2024, began with a kick-off meeting to define scope, followed by eight virtual meetings. A comprehensive literature review informed the identification of relevant clinical outcomes, patient-reported outcomes, treatment-related complications, and case-mix variables. A three-round Delphi process was used to reach consensus on key outcomes and follow-up intervals. Outcomes were included in the final set if at least 80% of OWG members rated them between 7 and 9 on a 9-point scale. Validation was conducted through surveys with 95 patients and 106 healthcare professionals from fields such as dietetics, obesity medicine, and general practice. Findings: The OWG developed a standardised set of 20 outcome measures, comprising 17 core measures and 3 population-specific measures. These span domains including physical health, psychosocial well-being, health behaviours, body functioning, and adverse events. Specific measures were also developed for bariatric surgery and female reproductive health (both pregnant and non-pregnant individuals). Key case-mix factors and appropriate follow-up periods were defined to support global consistency in reporting. Interpretation: Adoption of this standardised outcome set enables clinicians, patients, and stakeholders to identify care gaps, monitor outcomes, and evaluate the quality of obesity care against global benchmarks. Implementation can support the creation of a robust international data resource to guide research, inform clinical practice, and shape policy and guidelines for adult obesity treatment. Limitations include limited geographical diversity in validation surveys, the exclusion of internalised weight bias due to a lack of validated measurement tools, and limited applicability to individuals with obesity and multiple comorbidities. Funding: Novo Nordisk, Eli Lilly, and Boehringer Ingelheim International GmbH.</p>}},
  author       = {{Mekonnen, Teferi and Staniford, Leanne and Connell, Spencer and Das-Gupta, Zofia and DeSilva, Umanga and Saoud, Yasmine and Miller, Isabel and Mohan, Mohapradeep and Nienhuijs, Simon and Poddar, Megha and Deshmukh, Vaishali Chetan and Conradie-Smit, Marli and Teoh, Soo Huat and Sockalingam, Sanjeev and Huvinen, Emilia and Sbraccia, Paolo and Liem, Ronald and Vallis, Michael and Clare, Kenneth and Zvenyach, Tracy and Coulman, Karen and Ackermann, Marianela Aguirre and Vázquez-Velázquez, Verónica and Contreras, Yudith Preiss and Vidal, Josep and Urudinachi, Agbo and Tejeda-Muñoz, María Fernanda and Patton, Ian and Samuels, T. Alafia and Gabriel Salmon Leguede, Morgan Emile and Rigas, Georgia and Salas, Ximena Ramos and Crotty, Michael and Halpern, Bruno and Bessesen, Daniel and Pizzi, Laura and Al Hajeri, Omniyat Mohammed and Sharma, Arya M.}},
  issn         = {{2589-5370}},
  keywords     = {{Adult obesity; Clinical practice; ICHOM; Outcome measures; Patient-centred outcomes}},
  language     = {{eng}},
  publisher    = {{Lancet Publishing Group}},
  series       = {{EClinicalMedicine}},
  title        = {{Development of a core patient-centred outcome set for adults living with obesity : a modified delphi-based international consensus}},
  url          = {{http://dx.doi.org/10.1016/j.eclinm.2025.103422}},
  doi          = {{10.1016/j.eclinm.2025.103422}},
  volume       = {{87}},
  year         = {{2025}},
}