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Endocrine Health

The New ABCDs of Weight and Health

Photo: Courtesy of i yunmai on Unsplash

The world is bigger. It’s not that the planet itself has grown but, rather, people everywhere weigh more, and body shapes and fatness are changing. 

The U.S. obesity rate is approaching 40 percent. The challenge, despite all that has been learned from medical research, is that doctors and other healthcare professionals have not been able to help people significantly reverse unhealthy changes in body fat to improve their health.

Many people still firmly believe becoming overweight or obese is a lifestyle choice, and fault overweight individuals for making poor choices in meal content, meal frequency, and physical activity. However, science is now clear that obesity is a disease caused by interactions between the genes we have inherited, the environment we live in, and our behaviors. Some of these elements can be changed, but many cannot, such as genetics.

Defeating stereotypes

As a first step to advance the conversation surrounding excess weight, and because the word “obesity” is so loaded with negative associations, the American Association of Clinical Endocrinologists (AACE) has developed a new term; “adiposity-based chronic disease,” or ABCD for short.

The ABCD term focuses on the parts of the body that contain fat, or “adiposity.” This eliminates the stigma surrounding the term “obesity” and introduces the concept that this condition is a chronic disease, which means it can be serious, far-reaching, and must be managed throughout one’s lifetime.

In the model for ABCD, the risk, presence, and severity of adiposity complications are presented in three distinct stages:

  • Stage 1: The person is carrying extra weight but has no identifiable health complications from it.
  • Stage 2: The person has mild or moderate complications as a result of excess body weight.
  • Stage 3: The person has severe complications due to excess weight.

More than weight

ABCD is not just related to having too much fat in the body, but also having an unhealthy distribution of fat (i.e., too much fat in the belly or various organs, such as the liver, around the heart, or in muscle), and/or having abnormal fat that produces unhealthy proteins that cause problems with other parts of the body. This can lead to diabetes, increased blood fats (such as cholesterol), high blood pressure, and heart disease.

The ABCD strategy includes recognizing the negative effects of abnormal adiposity on health, referred to as “complications,” such as:

  • Type 2 diabetes mellitus
  • Hypertension 
  • Arthritis
  • Depression
  • Sleep problems
  • Cancer
  • Heart disease

Moving the conversation forward

Recognizing and treating complications from abnormal adiposity is important, but the key to staying healthy and living a longer and happier life is not just treating the complications from abnormal adiposity, but preventing or mitigating them.

AACE hopes the new adiposity-based chronic disease terminology, and ABCD medical care plan will significantly help improve the health of you and those around you.

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