The proposed disease classification system is based on the concept of obesity-based chronic disease (ABCD). The diagnostic term reflects both the pathophysiology and the clinical impact of obesity as a chronic disease..

The proposed coding system has four areas: pathophysiology, body mass index (BMI) classification, complications, and severity of complications; and includes the stage of the disease, specific complications that affect health, the basis for clinical intervention, individual treatment goals, and a personalized approach to medicine..

" Timothy Garvey, MD, Professor Butterworth. Department of Nutritional Sciences and Director of the Diabetes Research Center at the University of Alabama at Birmingham. Garvey is also a GRECC researcher and staff doctor at Birmingham Veterans Affairs Medical Center.. Garvey is the corresponding author of the study.

The diagnosis of obesity is currently based only on BMI, which does not indicate the impact of excess obesity on human health.. The International Classification of Diseases (ICD) code for obesity reads "

“These shortcomings lead to patients not having access to evidence-based treatments and seeing obesity as a chronic disease,” Garvey said..

The American Association of Clinical Endocrinologists (AACE) and the European Association for the Study of Obesity (EASO) have adopted the concept of ABCD.

“Around the world, there is a growing realization that BMI and other simple indicators of obesity do not accurately reflect the complexity of the disease or the circumstances of patients.. Garvey and Mechanic's proposal for a scientifically accurate and medically acceptable four-domain classification system is welcome, and builds on previous AACE and EASO initiatives to explain obesity as an " It is time for obesity to enter the era of precision medicine with new classification systems based on functionally established endpoints,” said Gema Frubeck, first author of the EASO paper on ABCD.

“AACE has historically supported efforts to advance the clinical evaluation and treatment of obesity beyond simply a weight-based disease based on BMI, including recommendations for more accurate diagnosis based on examination and clinical evaluation to classify and rank disease severity.. to correlate the intensity of therapy with the severity of the disease and the pathophysiology of the disease, thus the AACE followed its guidelines with a position statement proposing ABCD as a new diagnostic term for obesity. This proposed ICD coding framework supports clinical efforts to personalize individual diagnoses with greater accuracy and nuance, which will help personalized treatment plans for obese patients,” said Carl Nadolsky, DO, FACE, Chair of the Nutritional Conditions and Obesity Network at AACE.

" and Co-Director of the Weight Management Center at Wake Forest Baptist Health in Winston-Salem, NC. Ard was not associated with the study.

Ard added that the biggest problem he foresaw with this approach is that providers are currently diagnosing obesity with simple coding based on BMI.. “This more advanced approach will require significant education and outreach to change the behavior of providers. However, if better compensation is tied to this type of coding system, as the authors are aiming for, it could help stimulate wider adoption and implementation,” he said.. Ard.

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