Obesity: More than Meets the Eye: The Role of the Radiologist (2025)-S5-RCP21-2025

Video Transcription

Video Summary

The session frames obesity as a fast-growing global “pandemic” and a multisystem disease that cannot be assessed well with BMI or simple anthropometrics. Michel Pansini argues obesity is accelerating partly due to epigenetic “programming” across generations and that its complications vary by organ and patient, making imaging essential. He highlights the rise of GLP‑1–based therapies and the need to measure true treatment effects beyond weight loss. He critiques DEXA for poor longitudinal accuracy and inability to distinguish muscle quality or fat infiltration, noting MRI can quantify visceral fat, ectopic organ fat, muscle volume, and muscle fat infiltration, revealing meaningful multi-organ improvements even with <5% weight loss. He advocates “opportunistic screening”: extracting metabolic phenotypes from routine abdominal scans using AI segmentation without additional imaging.<br /><br />Louisa Thomas describes the UK Biobank’s large-scale neck-to-knee MRI and automated deep-learning pipeline that enabled population-level measures of fat distribution, organ fat, muscle quality, and organ shape. Imaging biomarkers often predict disease better than blood markers and reveal rapid worsening (more visceral fat, less muscle) over just two years.<br /><br />A final talk reviews interventions (diet, exercise, drugs, surgery) and imaging targets such as epicardial/perivascular fat, liver PDFF and corrected T1, and renal sinus fat, emphasizing opportunities for CT/MRI-based opportunistic screening and personalized monitoring across organs and ethnicities.

Keywords

obesity as multisystem disease

MRI body composition imaging

visceral and ectopic fat quantification

muscle volume and fat infiltration

GLP-1 therapies treatment monitoring

opportunistic screening with AI segmentation

UK Biobank neck-to-knee MRI pipeline

imaging biomarkers (liver PDFF, cT1, epicardial fat)