geoffrey modest medical blogs

  a European group redefined obesity, rejecting BMI as the standard, resulting in a very large number of people in the US being reclassified as obese (see   obesity new defn not BMI JAMAopen2025  in dropbox, or doi:10.1001/jamanetworkopen.2025.37619). i will state in advance, and explain more later below, that to me this is clearly a valid and clinically important revision....   Background : -- an international commission of 58 experts spanning multiple specialties and countries developed a new definition of obesity that incorporates some anthropometrics and/or direct measures of visceral body fat to better focus on this clinically important adipose tissue excess; these new guidelines achieved a 90 to 100% agreement within the committee and have already been endorsed by at least 76 professional organizations (see  https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00316-4/abstract ...

  A recent article found that adults with a provoked venous thromboembolism (VTE) and enduring risk factors are still at risk for a recurrent VTE event and do benefit from long-term anticoagulation, in the company-funded HI-PRO study  (see  dvt provoked prolonged anticoag NEJM2025  in dropbox, or DOI: 10.1056/NEJMoa2509426)   Details : -- 600 adults who had had an objectively-confirmed symptomatic venous thromboembolism (VTE) after a transient provoking risk factor (eg, autoimmune disorders, chronic lung disease, obesity) and had completed the at least 3-month course of anticoagulation were randomized to apixaban 2.5mg twice a day vs placebo for 12 months, in this single-center, double-blind trial done at the Brigham and Women's Hospital in Boston from November 2020 through November 2023 --mean age 59.5, 57% female, 81% white/12% Black/ 9% Latino -- BMI 31, current smokers 5%  -- coexisting conditions: VTE prior to this trial in 21%; diabetes...