Obesity Pillars 5 (2023)100056Contents lists available at ScienceDirectOBESITYPILLARSObesity PillarsELSEVIERjournal homepage:www.journals.elsevier.com/obesity-pillarsReviewObesity,diabetes mellitus,and cardiometabolic risk:An Obesity MedicineAssociation (OMA)Clinical Practice Statement (CPS)2023Harold Edward Bays,Shagun Bindlish,Tiffany Lowe Claytona Louisville Membolic and Atherosderosis Research Center,University of Louisville School of Medidne 3288 Ilinois Avee,Louisville KY,40213,USADiabetology,One Medical Adunct Faculty Touro University,CA,USACampbell University School of Osteopathic Medicine,Buies Creek,NG 27546,USAARTICLE INFOABSTRACTBackground:This Obesity Medicine Association (OMA)Clinical Practice Statement (CPS)is intended to provideAdiposopathyclinicians an overview of type 2 diabetes mellitus (T2DM),an obesity-related cardiometabolic risk factor.Diabetes mellitusCardiometabolicMethods The scientific support for this CPS is based upon published citations and clinical perspectives of OMAauthorsObesityResults:Topics include T2DM and obesity as cardiometabolic risk factors,definitions of obesity and adiposopathy,and mechanisms for how obesity causes insulin resistance and beta cell dysfunction.Adipose tissue is an activeimmune and endocrine organ,whose adiposopathic obesity-mediated dysfunction contributes to metabolic ab-normalities often encountered in clinical practice,including hyperglycemia (e.g.,pre-diabetes mellitus andT2DM).The determination as to whether adiposopathy ultimately leads to clinical metabolic disease depends oncrosstalk interactions and biometabolic responses of non-adipose tissue organs such as liver,muscle,pancreas,kidney,and brain.Conclusions:This review is intended to assist clinicians in the care of patients with the disease of obesity andT2DM.This CPS provides a simplified overview of how obesity may cause insulin resistance,pre-diabetes,andT2DM.It also provides an algorithmic approach towards treatment of a patient with obesity and T2DM,with"treat obesity first"as a priority.Finally,treatment of obesity and T2DM might best focus upon therapies that notonly improve the weight of patients,but also improve the health outcomes of patients (e.g,cardiovascular diseaseand cancer).1.Introductiondeath after about 60 days and a 35%weight loss.A patient with extremeobesity may survive prolonged fasting for as much as over one-yearBeginning in 2013,the Obesity Medicine Association (OMA)createdconsuming acaloric fluids,vitamins and minerals,with a reduction inand maintained an online Adult "Obesity Algorithm"(i.e.,educational60%body weight [4].However,adipocytes and adipose tissue have vitalslides and eBook)that underwent yearly updates by OMA authors andfunctions well beyond energy storage alone.Disruption of healthy adi-was reviewed and approved annually by the OMA Board of Trustees [1].pose tissue function leads to adverse health consequences such as hy-This was followed by a similar Pediatric "Obesity Algorithm"with u
