The association between severity of King’s Obesity Staging Criteria scores and treatment choice in patients with morbid obesity: a retrospective cohort study

Table 1 King’s obesity staging criteria as applied in the 2142 consecutive treatment seeking patients with morbid obesity

Criteria		Stage 0 Normal health	Stage 1 At risk of disease	Stage 2 Established disease	Stage 3 Advanced disease
A	Airways	Normal Neck < 43 cm	Mild OSA Neck ≥ 43 cm Asthma/COPD	Requires CPAP	-
B	BMI	NA^a	35-39.9 kg/m²	40-50 kg/m²	>50 kg/m²
C	CV-risk	<10%	10-19%	≥20% Stable CAD
D	Diabetes	FPG < 5,6 HbA1 < 5,7	IFG HbA1c 5.7-6.4%	DM2 HbA1c < 9%	DM2 HbA1c ≥ 9%
E	Economic complications	None	None	Workplace disadvantage	Disabled
F	Functional limitation	≥3 h moderate physical activity/week	1-2 h moderate physical activity/week	<1 h moderate physical activity/week	-
G	Gonadal dysfunction^b	Normal	Hyperandrogenemia^c	PCOS^d	-
H	Perceived Health status, body Image	Normal	Anxiety/depression without medication	Psycoactive drugs Eating disorder	-
I	Perceived Health status, body Image	Normal	Anxiety/depression without medication	Psycoactive drugs Eating disorder	-

OSA, obstructive sleep apnea, COPD, chronic obstructive pulmonary disease, CPAP, continuous positive airway pressure, BMI, body mass index, CV-risk, ten years risk of cardiovascular disease (Framingham risk assessment), CAD, coronary artery disease, FPG, fasting plasma glucose, IFG, impaired fasting glucose, DM2, diabetes mellitus type 2, PCOS, polycystic ovarian syndrome
^a Patients with BMI < 35 kg/m² (n = 42) were excluded from the analysis since they did not fulfil the criteria for bariatric surgery
^bFemale participants
^cHyperandrogenemia denotes a free testosterone index (FTI) above the normal range (FTI > 0.6). FTI was calculated by the formula 100 x serum testosterone (nmol/L) / sex hormone binding globulin (SHBG, nmol/L)
^dWomen with known PCOS and those with an FTI > 0.6 or hirsutism combined with oligo- / anovulation were classified as having PCOS

ISSN: 2052-9538