American Association of Clinical Endocrinologists and American College of Endocrinology position statement on the 2014 advanced framework for a new diagnosis of obesity as a chronic disease
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Weight gain together with cardiometabolic disease exacerbates insulin resistance and leads to greater storage of fat in the intra-abdominal depot, ectopic accumulation of fat in liver and muscle cells, and heightened dysregulation of adipocytokines and systemic inflammation.
“Although lean individuals can have insulin resistance and CMD, weight gain together with CMD exacerbates insulin resistance and leads to greater storage of fat in the intra-abdominal depot, ectopic accumulation of fat in liver and muscle cells, and heightened dysregulation of adipocytokines and systemic inflammation.670–673”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [671]
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Experimental — accuracy not yet measuredAt the core of CMD is an insulin-resistant state characterized by a glucoregulatory defect accompanied by multiple biochemical abnormalities involving molecular signaling, gene expression, oxidative stress, mitochondrial dysfunction, and accumulation of inflammatory macrophages in adipose tissue that alters release of adipocytokines into the circulation.
“At the core of CMD is the insulin-resistant state characterized by a glucoregulatory defect (ie, normal or elevated glycemia in the face of hyperinsulinemia) accompanied by multiple biochemical abnormalities involving molecular signaling, gene expression, oxidative stress, mitochondrial dysfunction, and accumulation of inflammatory macrophages in adipose tissue that alters release of adipocyt”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [671]
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Experimental — accuracy not yet measuredRecently, the AACE and the American College of Endocrinology developed an advanced framework for defining obesity as a chronic disease characterized by pathophysiological processes that result in increased adipose tissue mass and can result in increased morbidity and mortality, with MetS as one such important consequence.
“Recently, the AACE and the American College of Endocrinology developed an advanced framework for defining obesity as a chronic disease characterized by pathophysiological processes that result in increased adipose tissue mass and can result in increased morbidity and mortality (40), with MetS as 1 such important consequence.”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [40]
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“Weight loss should be considered in all overweight and obese patients with prediabetes or T2D, given the known therapeutic effects of weight loss to lower glycemia, improve the lipid profile, reduce BP, prevent or delay the progression to T2D in patients with prediabetes, and decrease mechanical strain on the lower ex…”
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“The quantity of body fat mass can correlate with certain adverse clinical endpoints or adiposity-based complications but is inadequately reflected by BMI (8-10).”
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“Weight loss should be considered in all patients with overweight or obesity who have prediabetes or T2D, given the known therapeutic effects of weight loss to lower glycemia, improve the lipid profile, reduce BP, prevent or delay the progression to T2D in patients with prediabetes, and decrease mechanical strain on th…”
BackgroundSelf-citationThe CardioMetabolic Health Alliance
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BackgroundCardiovascular Safety of Lorcaserin in Overweight or Obese Patients
Bohula, E. A., Wiviott, S. D., McGuire, D. K., Inzucchi, S. E., Kuder, J., Im, K., Fanola, C. L., Qamar, A., Brown, C., Budaj, A., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1808721 · Cited by 265 · see citing works
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Self-citationOvercoming Weight Bias in the Management of Patients With Diabetes and Obesity
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“The American Association of Endocrinologists has advanced a complications-centric approach to weight loss therapy, which advocates for more aggressive treatment in those patients with obesity with complications or at higher risk of complications in order to optimize outcomes, the benefit/risk ratio of the intervention…”
BackgroundSelf-citationNew horizons. A new paradigm for treating to target with second-generation obesity medications
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“As a consequence, stakeholders vested in the social consequences of obesity find it difficult to embrace obesity as a term for concerted action (29,33).”
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“Patients with overweight and obesity require secondary prevention and treatment, or tertiary interventions if there are associated weight-related complications (3), as is the case with other diseases such as type 2 diabetes and hypertension.”
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Self-citationLeptin, An Adipokine With Central Importance in the Global Obesity Problem
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“Key drivers in the context of ABCD and leptin include food overconsumption (driven by both environmental factors and pathophysiological hormonal regulation), insulin resistance, leptin resistance, and inflammation.”
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“Both of these systems combine anthropometric and clinical components to provide obesity diagnoses that reflect disease severity (22,37).”
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Self-citationFelsenreich, D. M., Steinlechner, K., Langer, F. B., Vock, N., Eichelter, J., Bichler, C., Jedamzik, J., Mairinger, M., Kristo, I., & Prager, G. (2022) · Obesity Surgery · doi:10.1007/s11695-021-05866-0 · Cited by 60 · see citing works
“It becomes more and more generally accepted that morbid obesity is a chronic recurrent disease that may not be cured by a single surgical procedure in some cases [1].”
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THE CONCEPT OF NOVEL NATIONAL CLINICAL GUIDELINES ON OBESITY
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“Overweight and obesity have been established as risk factors for diabetes [1].”
BackgroundFelsenreich, D. M., Langer, F. B., Eichelter, J., Jedamzik, J., Gensthaler, L., Nixdorf, L., Gachabayov, M., Rojas, A. E., Vock, N., Zach, M. L., et al. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10040674 · Cited by 45 · see citing works
“It massively impairs patients’ quality of life as well as their life expectancy, and has turned out to be a chronic disease that is difficult to cure [2].”
BackgroundGuo, F., & Garvey, W. T. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-2691 · Cited by 44 · see citing works
“This is consistent with the complicationscentric algorithm for obesity management (35) as advocated by the American Association of Clinical Endocrinologists that targets more aggressive therapy to those patients who will benefit most from the intervention based on risk and severity of weight-related complications (36).”
MethodSelf-citationOutcomes in a digital weight management intervention with one-on-one health coaching
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“Progressing gradually over a period of years, obesity is a pernicious condition associated with increased risk for more than 50 other diseases, including type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea, depression, gastroesophageal reflux disease (GERD), nonalcoholic fatty liver disease, osteoarth…”
BackgroundVISCERAL ADIPOSITY AS A GLOBAL FACTOR OF CARDIOVASCULAR RISK
Chumakova, G. A., Kuznetsova, Т. Y., Druzhilov, М. A., & Veselovskaya, N. G. (2018) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2018-5-7-14 · Cited by 43 · see citing works
Predicting risk of obesity in overweight adults using interpretable machine learning algorithms
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“A complication-centric approach may be adopted to guide the selection of weight loss therapy options (eg, more aggressive treatment in those obese patients with complications or at higher risk of complications to optimize outcomes, the benefit–risk ratio of the intervention, and the cost-effectiveness of care).(48,49)…”
MethodSelf-citationWeight Management in Obstructive Sleep Apnea
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“Obesity rates are increasing rapidly worldwide, and this is associated with many health problems [22, 23].”
BackgroundMetabolically Healthy Obesity: Personalised and Public Health Implications
Phillips, C. M. (2016) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2016.02.001 · Cited by 36 · see citing works
“Recently, the American Association of Clinical Endocrinologists suggested a complicationcentric approach to weight-loss management, advocating more aggressive therapeutic approaches for those patients with obesity-related complications [11].”
Lorcaserin and Renal Outcomes in Obese and Overweight Patients in the CAMELLIA-TIMI 61 Trial
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The Design of a GLP‐1/PYY Dual Acting Agonist
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Obesity as a Disease: Current Policies and Implications for the Future
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Clinical Definition of Overweight and Obesity
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Self-citationGuidelines for Obesity Management
Ryan, D. H. (2016) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2016.04.003 · Cited by 32 · see citing works
Assessing the relationship between a body shape index and mortality in a group of middle-aged men
He, S., Zheng, Y., Wang, H., & Chen, X. (2016) · Clinical Nutrition · doi:10.1016/j.clnu.2016.09.003 · Cited by 32 · see citing works
Chen, J., Li, M., Hao, B., Cai, Y., Li, H., Zhou, W., Song, Y., Wang, S., & Liu, H. (2021) · BMC Cardiovascular Disorders · doi:10.1186/s12872-021-02080-9 · Cited by 32 · see citing works
“However, existing evaluation indicators such as body mass index (BMI) evaluate systemic obesity but fail to evaluate the fat or muscle tissue proportion in the body [10].”
BackgroundPagano, E. S., Spinedi, E., & Gagliardino, J. J. (2016) · Neuroendocrinology · doi:10.1159/000453317 · Cited by 31 · see citing works
Obesity: a 100 year perspective
Bray, G. A. (2024) · International Journal of Obesity · doi:10.1038/s41366-024-01530-6 · Cited by 35 · see citing works
“…in an extraordinary degree, may be reckoned as a disease, as in some measure obstructs the free exercise of the animal functions; and hath a tendency to shorten life, by paving the way to dangerous distempers ” Several recent papers have supported Flemyng ’ s opinion from 250 years ago [126 – 129].”
Self-citationImplementing Culinary Medicine Training: Collaboratively Learning the Way Forward
Sicker, K., Habash, D., Hamilton, L. A., Nelson, N. G., Robertson-Boyd, L., & Shaikhkhalil, A. K. (2020) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2019.12.009 · Cited by 29 · see citing works
Obstructive Sleep Apnea as a Cardiovascular Risk Factor—Beyond CPAP
Bock, J. M., Vungarala, S., Karim, S., & Somers, V. K. (2021) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2021.01.027 · Cited by 29 · see citing works
Pahwa, R., ADAMS-HUET, B. A., & Jialal, I. (2017) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2017.02.010 · Cited by 29 · see citing works
Goday, A., Barneto, I., García‐Almeida, J. M., Blasco, A., Lecube, A., Grávalos, C., de Icaya, P. M., Peñas, R. D. L., Monereo, S., Vázquez, L., et al. (2015) · Clinical & Translational Oncology · doi:10.1007/s12094-015-1306-y · Cited by 28 · see citing works
Li, J.-Y., Wang, Y., Qi, X.-Y., Li, R., Hong, T., Yang, J., Yan, B., Liao, Z., Liu, J., & Xiao, X. (2019) · Clinica Chimica Acta · doi:10.1016/j.cca.2019.03.006 · Cited by 28 · see citing works
Hwang, I. C., Bae, J. H., & Kim, J. M. (2019) · Eye · doi:10.1038/s41433-019-0352-z · Cited by 26 · see citing works
Awosika, O., Eleryan, M. G., Rengifo‐Pardo, M., Doherty, L., Martin, L. W., & Ehrlich, A. (2018) · Europe PMC (PubMed Central) · Cited by 25 · see citing works
Eating disorders and disordered eating in servicemen and women: A narrative review
Gaviria, D., & Ammerman, A. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23424 · Cited by 24 · see citing works
Comprehensive Evaluation for Obesity: Beyond Body Mass Index
Cetin, D. C., Lessig, B. A., & Nasr, E. C. (2016) · Journal of Osteopathic Medicine · doi:10.7556/jaoa.2016.078 · Cited by 24 · see citing works
Rodriguez-Lozada, C., Cuervo, M., Cuevas‐Sierra, A., Goñi, L., Riezu‐Boj, J. I., Navas‐Carretero, S., Milagro, F. I., & Martínez, J. A. (2019) · Nutrients · doi:10.3390/nu11061206 · Cited by 23 · see citing works
“Obesity has been associated with physiological impairments, where a reduction in weight focused on caloric restriction with a good adherence, and an increase in physical activity may produce overall health benefits, including psychological traits [15].”
BackgroundObesity in kidney transplantation
Cocco, P. D., Okoye, O. T., Almario, J., Benedetti, E., Tzvetanov, I. G., & Spaggiari, M. (2019) · Transplant International · doi:10.1111/tri.13547 · Cited by 23 · see citing works
Nieto-Martínez, R. E., Gonzalez-Rivas, J. P., Lima-Martínez, M. M., Stepenka, V., Rísquez, A., & Mechanick, J. I. (2016) · Annals of Global Health · doi:10.1016/j.aogh.2015.11.002 · Cited by 22 · see citing works
Self-citationHayes, S. M., Wolf, C., Labbé, S., Peterson, E., & Murray, S. (2017) · Journal of Communications In Healthcare · doi:10.1080/17538068.2016.1270874 · Cited by 22 · see citing works
“American College of Endocrinology, and the Obesity Medicine Association.(5,13,14) In spite of these guidelines, a lack of competency and willingness to provide”
BackgroundShi, S., Ni, L., Tian, Y., Zhang, B., Xiao, J., Xu, W., Gao, L., & WU, X.-Y. (2023) · Journal of Diabetes Research · doi:10.1155/2023/3819830 · Cited by 21 · see citing works
“Obesity is considered to be one of the established risk factors for diabetes mellitus (DM) and the development of vascular complications [1, 2].”
BackgroundLu, F., Fan, J., Li, F., Liu, L., Chen, Z., Tian, Z., Zuo, L., & Yu, D. (2023) · Abdominal Radiology · doi:10.1007/s00261-023-04062-1 · Cited by 21 · see citing works
“Obesity is a risk factor for hemodynamic, endothelial, and inflammatory disorders and promotes the development of T2DM and renal damage [11–13].”
Santoro, G., Alfred, J., Rehman, A., Sheriff, N., Naing, H. M., & Tandon, A. (2024) · Annals of The Royal College of Surgeons of England · doi:10.1308/rcsann.2024.0054 · Cited by 18 · see citing works
Demmer, D. L., Beilin, L. J., Hands, B. P., Burrows, S., Pennell, C. E., Lye, S. J., Mountain, J. A., & Mori, T. A. (2016) · PLoS ONE · doi:10.1371/journal.pone.0162164 · Cited by 18 · see citing works
Attitudes and perceptions of the general public on obesity and its treatment options in Singapore
Lee, P. C., Ganguly, S., Tan, H. C., Lim, C. H., Chan, W. H., Kovalik, J.-P., Eng, A., Tan, J., Lim, E., Chua, J., et al. (2019) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2019.03.007 · Cited by 18 · see citing works
Wedin, S., & Edwards-Hampton, S. A. (2015) · Psychology Research and Behavior Management · doi:10.2147/prbm.s69132 · Cited by 18 · see citing works
Nieto-Martínez, R. E., Gonzalez-Rivas, J. P., Florez, H. J., & Mechanick, J. I. (2016) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2016.06.002 · Cited by 18 · see citing works
Self-citationTayefi, M., Tayefi, B., Darroudi, S., Mohammadi‐Bajgiran, M., Mouhebati, M., Heidari‐Bakavoli, A., Ebrahimi, M., Ferns, G. A., Esmaily, H., Dabaghian, M., et al. (2019) · Translational Metabolic Syndrome Research · doi:10.1016/j.tmsr.2019.08.001 · Cited by 18 · see citing works
Chen, Z., Cao, B., Liu, L., Tang, X., & Xu, H. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1304127 · Cited by 17 · see citing works
Nutrition Interventions for Obesity
Ard, J. D., Miller, G., & Kahan, S. I. (2016) · Medical Clinics of North America · doi:10.1016/j.mcna.2016.06.012 · Cited by 17 · see citing works
NATIONAL CLINICAL RECOMMENDATIONS FOR OBESITY: CONCEPT AND PROSPECTS
Nedogoda, S. V., Barykina, I. N., & Salasyuk, A. S. (2017) · Journal of Volgograd State Medical University · doi:10.19163/1994-9480-2017-1(61)-134-140 · Cited by 17 · see citing works
“ожирения [13], главной особенностью которой стало признание, что ожирение является хроническим заболеванием со специфическим набором осложнений и признанием факта наличия «метаболически здорового» ожирения.”
Feng, X., Wang, J., Wang, S., Wang, Z., Wu, S., Wei, Y., Li, L., Shen, T., & Chen, Q. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1122509 · Cited by 16 · see citing works
“About two-thirds of patients with type 2 diabetes are overweight or obese, and abdominal obesity accounts for about 50% (11).”
BackgroundCzerwińska, M., Czarzasta, K., & Cudnoch‐Jędrzejewska, A. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.692642 · Cited by 15 · see citing works
Mechanick, J. I., Harrell, R., Allende-Vigo, M. Z., Alvayero, C., Arita-Melzer, O., Aschner, P. J., Camacho, P. M., Castillo, R. Z., Cerdas, S., Coutinho, W. F., et al. (2016) · Endocrine Practice · doi:10.4158/ep161229.gl · Cited by 17 · see citing works
“Refer to AACE/ACE advanced framework for comprehensive overweight/obesity management (66).”
BackgroundMethodSelf-citationGonzalez-Rivas, J. P., Mechanick, J. I., Hernández, J., Infante-García, M. M., Pavlovska, I., Medina‐Inojosa, J. R., Kunzová, Š., Nieto-Martínez, R. E., Brož, J., Busetto, L., et al. (2021) · Obesity Science & Practice · doi:10.1002/osp4.496 · Cited by 15 · see citing works
Self-citationAssociation of weight-adjusted waist index and diabetic kidney disease in type 2 diabetes mellitus
Ding, Y., Lv, S., Xie, R., Ye, W., Luo, Y., & Li, Y. (2023) · Endocrine Connections · doi:10.1530/ec-23-0491 · Cited by 15 · see citing works
“Both overweight and obesity have been identified as contributory factors in the initiation and progression of T2D and its attendant complications (16, 17, 18).”
BackgroundLi, M., Liu, Y., Jin, L., Zeng, N., Wang, L., Zhao, K., Lv, H., Zhang, M., Xu, W., Zhang, P., et al. (2019) · Obesity Surgery · doi:10.1007/s11695-019-04067-0 · Cited by 15 · see citing works
Pi-Sunyer, X., Shanahan, W. R., Fain, R., Ma, T., & Garvey, W. T. (2016) · Postgraduate Medicine · doi:10.1080/00325481.2016.1208618 · Cited by 14 · see citing works
Self-citationDeng, H., Lin, S., Yang, X., Lv, J., Luo, S., Zeng, L., Weng, J., Xu, W., & On Behalf of the CONFIDENCE Group (2018) · Journal of Diabetes · doi:10.1111/1753-0407.12883 · Cited by 16 · see citing works
“Weight loss should be considered in all overweight or obese patients with T2D, given the known therapeutic effects of weight loss on improvements in glucose levels, blood pressure, lipid profiles, and other metabolic indices.(4,5) Accordingly, a patient-centered approach recommended in recent management guidelines sho…”
BackgroundDuque, I. D. E. (2017) · Universitas Médica · doi:10.11144/javeriana.umed58-2.obes · Cited by 14 · see citing works
- Authors
- Garvey, W. T., Garber, A. J., Mechanick, J. I., Bray, G. A., Dagogo-Jack, S., Einhorn, D., Grunberger, G., Handelsman, Y., Hennekens, C. H., Hurley, D. L., McGill, J., Palumbo, P., & Umpierrez, G.
- Affiliations
- University of Alabama at Birmingham (US)
- Baylor College of Medicine (US)
- Icahn School of Medicine at Mount Sinai (US)
- Pennington Biomedical Research Center (US)
- University of Memphis (US)
- University of California San Diego (US)
- Wayne State University (US)
- Florida Atlantic University (US)
- Mayo Clinic (US)
- Washington University in St. Louis (US)
- Emory University (US)
- Corresponding author
- Garvey, W. Timothy
- ORCID
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 20
- Issue
- 9
- Pages
- 977-989
- ISSN
- 1530-891X (ISSN-L)
- PMC
- PMC4962331
- OpenAlex
- W2148224299
- Cited by
- 238
- References
- 12
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 13 · 2023: 23 · 2022: 18 · 2021: 23 · 2020: 15 · 2019: 18 · 2018: 28 · 2017: 22 · 2016: 35 · 2015: 22 · 2014: 1
- FWCI
- 62.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs (I01CX000432)
- Amgen
- GlaxoSmithKline
- Vivus
- Florida Atlantic University
- Stryker
- Intarcia Therapeutics
- Amarin Corporation
- Halozyme
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK020579, P30DK079626)
- Janssen Pharmaceuticals
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- obesity, American Association of Clinical Endocrinologists
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