Updated guidelines strive for obesity to be treated as a chronic condition

The obesity epidemic shows no signs of slowing, with an estimated 640 million people worldwide now considered obese. According to the CDC, every 2 of 3 adults are overweight or obese. Recently, the American Association of Clinical Endocrinologists (AACE), who declared obesity a disease in 2012, released evidence-based management guidelines that recommend obesity be approached as a chronic medical condition. Their rationale for the update? “Obesity medicine lacks comprehensive and evidence-based guidelines that are translatable to real-world clinical care of patients with obesity,” said AACE Obesity Scientific Committee Chair W. Timothy Garvey, MD.

The primary goal of obesity care according to the guidelines, is relief from weight-related complications and not just weight loss. Expanding on their 2014 obesity framework, the updated AACE guidelines encompass screening, diagnosis, evaluation, therapeutic decisions, treatment goals, and follow-up. A color-coded graphic algorithm and a separate statement about the importance of incorporating obesity management into the medical chronic-care model were also published with the executive summary of the guidelines in the May 24, 2016 issue of Endocrine Practice.

Included in the guidelines and algorithm are a scheme for obesity staging that uses anthropomorphic and clinical evaluations as well as body mass index (BMI). Certain ethnic groups have different BMI cutoffs and there are recommendations to screen for 16 weight-related comorbidities including type 2 diabetes or prediabetes. Clinicians can then make better informed decisions regarding the use of lifestyle modification, weight-loss medications, and when bariatric surgery should be considered.

The full guidelines will be published later this year.

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