The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) published a position statement that redefines and relabels the term obesity as Adiposity-Based Chronic Disease (ABCD), a condition that goes beyond the traditional focus of the body mass index (BMI). 

In 2012, the AACE described obesity as a disease state, which was officially adopted by the American Medical Association (AMA) in 2014. W. Timothy Garvey, MD, FACE, co-author of the position statement and chair of AACE’s Obesity Scientific Committee, stated, “For far too long, ‘obesity’ as defined by body mass index has been an imprecise and confusing term that fails to convey the health implications of excess weight.”

Now, the statement emphasizes the characteristic physiological effects of excess weight instead of the weight itself, standardizing the protocols for weight loss and managing complications while encouraging the overall acceptance of lifestyle medicine. This approach includes interventions such as nutrition, physical activity, and behavioral medicine to reduce disease risk and illness burden.

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The “adiposity-based” aspect refers to abnormalities in the mass, distribution, and/or function of adipose tissue. The “chronic disease” aspect refers to the related complications that lead to morbidity and mortality. The ABCD diagnostic term will be integrated into the AACE/ACE chronic care model. 

A second AACE/ACE Obesity Consensus Conference is anticipated for 2017 where implementation of the ABCD medical diagnosis will be discussed and how the recommended changes can be incorporated in ICD-10 diagnostic coding.

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