@article{9825878cc1c04bfb9885c0353af00848,
title = "American Association of Clinical Endocrinology Consensus Statement: Addressing Stigma and Bias in the Diagnosis and Management of Patients with Obesity/Adiposity-Based Chronic Disease and Assessing Bias and Stigmatization as Determinants of Disease Severity",
abstract = "Objective: To focus on the intersection of perception, diagnosis, stigma, and weight bias in the management of obesity and obtain consensus on actionable steps to improve care provided for persons with obesity. Methods: The American Association of Clinical Endocrinology (AACE) convened a consensus conference of interdisciplinary health care professionals to discuss the interplay between the diagnosis of obesity using adiposity-based chronic disease (ABCD) nomenclature and staging, weight stigma, and internalized weight bias (IWB) with development of actionable guidance to aid clinicians in mitigating IWB and stigma in that context. Results: The following affirmed and emergent concepts were proposed: (1) obesity is ABCD, and these terms can be used in differing ways to communicate; (2) classification categories of obesity should have improved nomenclature across the spectrum of body mass index (BMI) using ethnic-specific BMI ranges and waist circumference (WC); (3) staging the clinical severity of obesity based on the presence and severity of ABCD complications may reduce weight-centric contribution to weight stigma and IWB; (4) weight stigma and internalized bias are both drivers and complications of ABCD and can impair quality of life, predispose to psychological disorders, and compromise the effectiveness of therapeutic interventions; (5) the presence and of stigmatization and IWB should be assessed in all patients and be incorporated into the staging of ABCD severity; and (6) optimal care will necessitate increased awareness and the development of educational and interventional tools for health care professionals that address IWB and stigma. Conclusions: The consensus panel has proposed an approach for integrating bias and stigmatization, psychological health, and social determinants of health in a staging system for ABCD severity as an aid to patient management. To effectively address stigma and IWB within a chronic care model for patients with obesity, there is a need for health care systems that are prepared to provide evidence-based, person-centered treatments; patients who understand that obesity is a chronic disease and are empowered to seek care and participate in behavioral therapy; and societies that promote policies and infrastructure for bias-free compassionate care, access to evidence-based interventions, and disease prevention.",
keywords = "BMI, adiposity-based chronic disease, obesity, stigma, weight bias",
author = "Karl Nadolsky and Brandi Addison and Monica Agarwal and Almandoz, {Jaime P.} and Bird, {Melanie D.} and {DeGeeter Chaplin}, Michelle and Garvey, {W. Timothy} and Kyle, {Theodore K.}",
note = "Funding Information: This consensus statement on obesity stigma and weight bias was developed with financial support from the American Association of Clinical Endocrinology (AACE). All members who served on this AACE task force completed work on the manuscript electronically and met via video conferences. AACE received no outside funding for the development of this consensus statement. Volunteer authors on this task force received no remuneration for their participation in development of this consensus statement. Support for the 2022 AACE Obesity Consensus Conference – Improving Obesity Outcomes Together was provided by Novo Nordisk but the funder had no role in development of this consensus statement. Address correspondence to the American Association of Clinical Endocrinology, 7643 Gate Parkway, Suite 104-328, Jacksonville, FL 32256. Email address: publications@aace.com. Disclaimer: This document represents the official position of the American Association of Clinical Endocrinology on the subject matter at the time of publication. Subject matter experts who participated on the task force utilized their judgment and experience supported by relevant scientific evidence as available. Every effort was made to achieve consensus among the task force members. Consensus statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. We encourage health care professionals to use this information in conjunction with their best clinical judgment. The presented guidance may not be appropriate in all situations. Any decision(s) by health care professionals to apply this guidance provided in thisconsensus statement must be made in consideration of local resources and individual patient circumstances. AACE CONFIDENTIAL AND PROPRIETARY This document is copyright 2023 by AACE. All rights reserved. After publication, this document may be used for personal, non-commercial purposes only. No other uses of this document are allowed, in whole or in part, by any person or entity, including reproduction, retransmission, sharing, editing, or the creation of derivative works, without the prior written consent of AACE or before publication. Funding Information: This consensus statement on obesity stigma and weight bias was developed with financial support from the American Association of Clinical Endocrinology (AACE). All members who served on this AACE task force completed work on the manuscript electronically and met via video conferences. AACE received no outside funding for the development of this consensus statement. Volunteer authors on this task force received no remuneration for their participation in development of this consensus statement. Support for the 2022 AACE Obesity Consensus Conference – Improving Obesity Outcomes Together was provided by Novo Nordisk but the funder had no role in development of this consensus statement. Publisher Copyright: {\textcopyright} 2023 AACE",
year = "2023",
month = jun,
doi = "10.1016/j.eprac.2023.03.272",
language = "English (US)",
volume = "29",
pages = "417--427",
journal = "Endocrine Practice",
issn = "1530-891X",
publisher = "American Association of Clinical Endocrinology",
number = "6",
}