Adiposity-Based Chronic Disease (ABCD) is a new diagnostic term for obesity
Adiposity-Based Chronic Disease (ABCD) is a new diagnostic term for obesity that explicitly identifies a chronic disease, alludes to a precise pathophysiological basis, and avoids the stigmata and confusion related to the differential use and multiple meanings of the term “obesity”.
Key elements to further the care of patients using this new ABCD term are:
- positioning lifestyle medicine in the promotion of overall health, not only as the first algorithmic step, but as the central, pervasive action
- standardising protocols that comprehensively and durably address weight loss and management of adiposity-based complications
- approaching patient care through contextualisation (e.g., primordial prevention to decrease obesogenic environmental risk factors and transculturalisation to adapt evidence-based recommendations for different ethnicities, cultures, and socio-economics),
- developing evidence-based strategies for successful implementation, monitoring, and optimization of patient care over time.
Component and Description
- Healthy eating patterns: Aggregation of foods consumed over a specified time and associated with clinical benefit; addresses disordered eating with counselling, group therapy, cognitive behavioural therapy (CBT), and stimulus management
- Physical activity: Body movements (e.g., aerobic, strength training, sports, exercise, walking); can be employment-related and associated with reduced sedentary activity
- Body composition: Target %fat mass and fat distribution; implicates muscle mass and intracellular lipid storage
- Sleep hygiene: Amount and quality of sleep
- Stress reduction: Relaxation, yoga, meditation, counselling, and CBT
- Tobacco cessation: Counselling and CBT
- Alcohol moderation: Spectrum of alcohol use disorder; counselling, and CBT
- Substance abuse: Counselling and CBT
- Mood: Counselling, psychotherapy, medical therapy, and physical activity
- Behaviour: Focus on healthy/unhealthy behaviours; CBT
- Community engagement: Provide local resources (e.g., houses of worship, schools, neighbourhood centres)
- Transculturalisation: Adapt recommendations for different ethnicities/cultures
Mechanick JI, Hurley DL, Garvey WT. (2016) ADIPOSITY-BASED CHRONIC DISEASE AS A NEW DIAGNOSTIC TERM: AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND THE AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT. Endocr Pract. 2017 Mar;23(3):372-378.