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Current classification of obesity is based on the relative body weight and fat tissue distribution, it does not provide relevant information on functional status, quality of live and patient prognosis. A combination of obesity classes with 5 stages is being proposed, where the stages are defined by the presence of risk factors, obesity-related diseases and the level of functional impairment. Individual stages are associated with recommended preventive and treatment approaches.

Smoking and obesity represent the current leading preventable health risks. Smoking and obesity increase the risk of many types of cancer, both smoking and abdominal obesity are insulinoresistant states, leading to endothelial dysfunction and high cardiovascular morbidity and mortality. Combining obesity with current smoking increases the risk of premature death more than 10-fold; the risk for obesity increases with number of cigarettes per day. Maternal smoking and smoking in families represent higher risk for children overweight/obesity. Weight gain after smoking cessation may be moderate, mostly is temporary and may be reduced by appropriate education and supporting therapies.