A Dual-Stage Deep Learning Framework for Obesity Assessment with Ultrasound Image Segmentation and Severity Classification
Received: 26 October 2025 | Revised: 11 November 2025 and 18 November 2025 | Accepted: 19 November 2025 | Online: 27 December 2025
Corresponding author: Rohini Pawar
Abstract
Obesity is a major global health challenge associated with metabolic dysfunction and multi-organ impairment. Early detection of fat accumulation is critical but depended on the resolution and operator dependency of conventional ultrasound techniques. This study proposes a two-stage deep learning framework for automated segmentation and severity classification of obesity using abdominal ultrasound images. The pipeline integrates four encoder–decoder architectures (ENet, SegNet, U-Net, and U-Net++) for precise fat-layer segmentation, followed by convolutional neural networks (LeNet-5, VGG19, ResNet50, and EfficientNetB0) for four-level obesity severity classification. A curated dataset of 550 radiologist-annotated ultrasound images was used for training and evaluation. The U-Net++ model achieved the highest segmentation performance with a Dice coefficient of 0.986 and an Intersection over Union of 0.973, while EfficientNetB0 recorded a superior classification accuracy of approximately 97% with stable validation performance. The results demonstrate that ultrasound-based deep learning pipelines can deliver reliable, non-invasive, and cost-effective solutions for early obesity detection, offering strong potential for integration into routine diagnostic practice.
Keywords:
ultrasound imaging, obesity assessment, deep learning, U-Net , EfficientNetB0, image segmentation, classificationDownloads
References
"Obesity and overweight," WHO, Dec. 08, 2025. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
J. A. M. J. L. Janssen, "The Causal Role of Ectopic Fat Deposition in the Pathogenesis of Metabolic Syndrome," International Journal of Molecular Sciences, vol. 25, no. 24, Dec. 2024. DOI: https://doi.org/10.3390/ijms252413238
H. Kiyoyama et al., "Association of visceral fat obesity with structural change in abdominal organs: fully automated three-dimensional volumetric computed tomography measurement using deep learning," Abdominal Radiology, vol. 50, no. 9, pp. 4395–4402, Sep. 2025. DOI: https://doi.org/10.1007/s00261-025-04834-x
T.-H. Chou et al., "Deep learning for abdominal ultrasound: A computer-aided diagnostic system for the severity of fatty liver," Journal of the Chinese Medical Association, vol. 84, no. 9, Sep. 2021, Art. no. 842. DOI: https://doi.org/10.1097/JCMA.0000000000000585
S. M. Shaaban, M. Nawaz, Y. Said, and M. Barr, "An Efficient Breast Cancer Segmentation System based on Deep Learning Techniques," Engineering, Technology & Applied Science Research, vol. 13, no. 6, pp. 12415–12422, Dec. 2023. DOI: https://doi.org/10.48084/etasr.6518
Y. K. Desai, "Diagnosis of Medical Images Using Convolutional Neural Networks," Journal of Electrical Systems, vol. 20, no. 6s, pp. 2371–2376, May 2024. DOI: https://doi.org/10.52783/jes.3220
P. Dong et al., "An ultrasound image segmentation method for thyroid nodules based on dual-path attention mechanism-enhanced UNet++," BMC Medical Imaging, vol. 24, no. 1, Dec. 2024, Art. no. 341. DOI: https://doi.org/10.1186/s12880-024-01521-z
C. Zhu et al., "Swin-Net: A Swin-Transformer-Based Network Combing with Multi-Scale Features for Segmentation of Breast Tumor Ultrasound Images," Diagnostics, vol. 14, no. 3, Jan. 2024, Art. no. 269. DOI: https://doi.org/10.3390/diagnostics14030269
A. Pati, S. R. Addula, A. Panigrahi, B. Sahu, D. S. K. Nayak, and M. Dash, "Artificial intelligence in improving disease diagnosis: A case study of cardiovascular disease prediction," in Artificial Intelligence in Medicine and Healthcare, A. Kumar, S. Rani, S. Rathee, N. Hemrajani, and M. Dahiya, Eds. CRC Press, 2025. DOI: https://doi.org/10.1201/9781003508595-2
T. Kim, D. H. Lee, E.-K. Park, and S. Choi, "Deep Learning Techniques for Fatty Liver Using Multi-View Ultrasound Images Scanned by Different Scanners: Development and Validation Study," JMIR Medical Informatics, vol. 9, no. 11, Nov. 2021, Art. no. e30066. DOI: https://doi.org/10.2196/30066
F. M. Alshagathrh, M. S. Househ, F. M. Alshagathrh, and M. S. Househ, "Artificial Intelligence for Detecting and Quantifying Fatty Liver in Ultrasound Images: A Systematic Review," Bioengineering, vol. 9, no. 12, Dec. 2022, Art. no. 748. DOI: https://doi.org/10.3390/bioengineering9120748
F. Alshagathrh et al., "Large annotated ultrasound dataset of non-alcoholic fatty liver from Saudi hospitals for analysis and applications," Data in Brief, vol. 58, Feb. 2025, Art. no. 111266. DOI: https://doi.org/10.1016/j.dib.2024.111266
H. M. Danish, Z. Suhail, and F. Farooq, "Deep learning-based automation for segmentation and biometric measurement of the gestational sac in ultrasound images," Frontiers in Pediatrics, vol. 12, Dec. 2024. DOI: https://doi.org/10.3389/fped.2024.1453302
M. S. White, A. Horikawa-Strakovsky, K. P. Mayer, B. W. Noehren, and Y. Wen, "Open-Source AI for Vastus Lateralis and Adipose Tissue Segmentation to Assess Muscle Size and Quality," Ultrasound in Medicine and Biology, vol. 51, no. 12, pp. 2276–2280, Dec. 2025. DOI: https://doi.org/10.1016/j.ultrasmedbio.2025.08.008
M. Hayat, S. Aramvith, S. Bhattacharjee, and N. Ahmad, "Attention GhostUNet++: Enhanced Segmentation of Adipose Tissue and Liver in CT Images." arXiv, Apr. 14, 2025. DOI: https://doi.org/10.1109/EMBC58623.2025.11254588
T.-J. Yen, C.-T. Yang, Y.-J. Lee, C. Chen, and H.-C. Yang, "Fatty liver classification via risk controlled neural networks trained on grouped ultrasound image data," Scientific Reports, vol. 14, no. 1, Mar. 2024, Art. no. 7345. DOI: https://doi.org/10.1038/s41598-024-57386-3
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Copyright (c) 2025 Rohini Pawar, Rohini Jadhav, Rohit Jadhav, Gagandeep Kaur, Rutuja Rajendra Patil

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