This article is more than 5 years old. Information may no longer be current.
AACE/ACE propose new name for obesity: Adiposity-based chronic disease
Click Here to Manage Email Alerts
The American Association of Clinical Endocrinologists and the American College of Endocrinology have introduced a new diagnostic term to replace the disease name of obesity, now referring to the condition as “adiposity-based chronic disease,” or ABCD, according to a joint position statement released by the two organizations.
The new term, according to the AACE/ACE Obesity Committee, is intended to shift the focus away from excess weight to the related comorbid conditions, with the goal of improving patient care and reducing stigma. The position statement was published online in Endocrine Practice.
“AACE/ACE has proposed the ‘ABCD’ diagnostic term to better reflect the pathophysiology and targeted therapy for obesity,” Jeffrey I. Mechanick, MD, FACP, FACE, FACN, ECNU, clinical professor of medicine at the Icahn School of Medicine at Mount Sinai, told Endocrine Today. “This term has two main advantages. First, ABCD relates to the adverse effects of adiposity beyond just an increased amount (that is, ABCD also includes abnormal distribution and function), and second, ABCD does not have the same stigmatization associated with the term ‘obesity,’ which may assist with implementation.”
The term “obesity,” Mechanick and colleagues noted, often causes confusion among the public and health care professionals alike, as the diagnosis is based solely on anthropometric measurement. The word itself conveys little about the conditions associated with it, they wrote, whereas BMI, a screening tool to estimate adiposity, “underperforms” as a predictor of health and the sole guide for decision making.
“Strategically, the ABCD conceptual approach is not a rebranding of obesity per se, but a novel approach that incorporates better healthy messaging for [health care providers] and patients,” the researchers wrote. This approach spans primordial/primary prevention to decrease the risks and adverse effects of abnormal adiposity mass, distribution, and/or function, to secondary/tertiary prevention to decrease the risks and adverse effects of adiposity-based complications.”
AACE and ACE plan to spearhead clear definition and positioning of ABCD in the human disease ontology database, followed by the creation of relevant, complication-based ICD-10 coding to facilitate reimbursement. Further research is needed to focus on specific tools to quantify derangements in adiposity mass, distribution and function, the researchers wrote.
“Now that AACE/ACE has introduced this term, the next step is to listen to and incorporate comments and criticism, refine and improve the management framework (which has already been transformed to one that is ‘complications-centric’ and not just ‘BMI-centric’), and begin a validation process at both individual patient and whole population levels,” Mechanick said.
AACE has also launched the Obesity Resource Center, which contains educational tools for members and other health care professionals who care for patients with obesity in developing an individualized care plan.
“According to the CDC, more than one-third of U.S. adults have obesity that translated into an estimated annual medical cost of $147 billion in 2008,” Alan J. Garber, MD, PhD, FACE, chief medical editor of Endocrine Today and chair of the Obesity Resource Center, said in a statement. “With proper treatment and management by a trained specialist, such as an endocrinologist, obesity-related conditions, such as diabetes, heart disease, stroke and cancer, can be prevented. The development of this new Obesity Resource Center is one way endocrinologists and other health care professionals can look for resources to help in the management and treatment of patients with obesity.” – by Regina Schaffer
Disclosure: Mechanick reports receiving honoraria for program development from Abbott Nutrition International and honoraria for lectures from the NCD Pre-Disease Forum. One author reports serving on advisory boards for or receiving research support from Alexion, AstraZeneca, Eisai, Elcelyx, Janssen, Lexicon, Merck, Novo Nordisk, Pfizer, Sanofi, Takeda, Vivus and Weight Watchers.
Click Here to Manage Email Alerts