An emergent concept from the Consensus Conference on Obesity, convened by AACE and the American College of Endocrinology (ACE) in March 2014, was that the current diagnostic definition of obesity, which relied on an anthropomorphic measure of body mass index (BMI), needed to be updated. BMI alone does not indicate how weight gain might be affecting the health of individual patients, and multiple stakeholders at the Consensus Conference saw this as a major obstacle to concerted action in combatting obesity.
The new obesity definition and diagnostic strategy is actionable, medically-meaningful and adds value to the health-promoting effects of weight loss.
Dr. W. Timothy Garvey, Chair of the AACE/ACE Consensus Conference on Obesity and Obesity Scientific Committee and author of the AACE/ACE Obesity Consensus Statement, added that, "This approach addresses a problem of diagnostic uncertainty and is the first step in removing the impediment for concerted and comprehensive action among health care professionals, health care systems, regulators, payers, and employers."
In 2011, AACE/ACE declared obesity as a chronic disease as did the American Medical Association in June 2013.
The new approach does not simply depend upon BMI alone, but also the impact of weight gain on health. A four-step approach is recommended for all patients: screening using BMI with adjustments for ethnic differences, clinical evaluation for the presence of obesity-related complications using a checklist, staging for the severity of complications using complication-specific criteria, and selection of prevention and/or intervention strategies targeting specific complications as guided by the AACE/ACE obesity management algorithm.
The next steps will be to obtain broad input and recommendations regarding the framework for the new diagnostic approach from participants at the Consensus Conference on Obesity. The goal is to assure broad-based acceptance, translation, and implementation of the diagnosis that will support concerted action around a rational and comprehensive plan to prevent and treat obesity.
Presented at the 2015 Meeting of the American Association of Clinical Endocrinologists.