In UK General practice, the trio of codes:
443371000124107 Obese class I (finding)
443381000124105 Obese class II (finding)
819948005 Obese class III (finding)
…are used vanishingly rarely, despite being available for selection since 2019. During 2024-25 they collectively managed just 4,360 outings in a population of 65 million souls.
By comparison, the older trio of:
162863004 Body mass index 25-29 - overweight (finding)
162864005 Body mass index 30+ - obesity (finding)
408512008 Body mass index 40+ - severely obese (finding)
…managed 1,876,900 new coded EPR instances in the same population and year.
But all are dwarfed by the 51,723,370 new coded instances in the same population and year using the observable code 60621009 Body mass index (observable entity) plus an actual absolute value.
The strong clinician preference is clearly to document BMI as its actual value, partly because this is objective and free of stigmatising “interpretation” and partly because it can be charted over time. When they DO choose to abstract from the actual value to a range of values, they appear to strongly prefer a terming choice that doesn’t go straight to the stigmatising diagnosis or to one that measures obesity on a severity grading scale. This may be partly because they’re not all immediately familiar with the diagnostic criteria for Grade I,II and III obesity, or because they have learnt the hard way that such grading schemes seldom prove stable on a scale of decades or one patient’s lifetime, and that such instability ultimately plays havoc with longitudinal coding.
I would therefore suggest that inactivating anything in favour of the Class I, II and III obesity codes would be a retrograde step in clinical usability.
(The code 722595002 |Overweight in adulthood with body mass index of 25 or more but less than 30 (finding)|, released to the world in 2017, has been used a grand total of 160 times during half a billion patient years of care. So nobody’s going to miss it…)