Endocrine Practice 29 (2023)417-427EndocrineMCEEndocrinePracticeAACEPracticeTMwww.endocrinepractice.orgAACE Consensus StatementAmerican Association of Clinical Endocrinology Consensus Statement:Addressing Stigma and Bias in the Diagnosis and Management of Patientswith Obesity/Adiposity-Based Chronic Disease and Assessing Bias andStigmatization as Determinants of Disease SeverityKarl Nadolsky,DO,FACE 1,Brandi Addison,DO,FACE 2,Monica Agarwal,MD,MEHP,FACE3,Jaime P.Almandoz,MD,MBA,FTOS4,Melanie D.Bird,PhD,MSAM 5,Michelle DeGeeter Chaplin,PharmD,BCACP,CDCESW.Timothy Garvey,MD,MACE 3,Theodore K.Kyle,RPh,MBA?Michigan State University College of Human Medicine,Grand Rapids,Michigan2 South Texas Endocrinology and Metabolism Center,Corpus Christi,Texas3 University of Alabama at Birmingham,Birmingham,AlabamaUniversity of Texas Southwestern Medical Center.Dallas,Texas5American Association of Chinical Endocrinology.Jacksonille,Florida6 Wingate University School of Pharmacy.Hendersonville,North CarolinaConscienHealth,Pittsburgh,PennsyvaniaARTIC LE INF OABSTRACTArtide history:Objective:To focus on the intersection of perception,diagnosis,stigma,and weight bias in theReceived 13 February 2023management of obesity and obtain consensus on actionable steps to improve care provided forReceived in revised formpersons with obesity.17 March 2023Methods:The American Association of Clinical Endocrinology (AACE)convened a consensus con-Accepted 18 March 2023ference of interdisciplinary health care professionals to discuss the interplay between the diagnosisAvailable online 4 May 2023of 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 inKey words:mitigating IWB and stigma in that context.adiposity-based chronic diseaseResults:The following affirmed and emergent concepts were proposed:(1)obesity is ABCD,andBMIthese terms can be used in differing ways to communicate:(2)classification categories of obesityobesityshould have improved nomenclature across the spectrum of body mass index (BMI)using ethnic-stigmaspecific BMI ranges and waist circumference(WC):(3)staging the clinical severity of obesity basedweight biason the presence and severity of ABCD complications may reduce weight-centric contribution toweight stigma and IWB:(4)weight stigma and internalized bias are both drivers and complicationsof ABCD and can impair quality of life,predispose to psychological disorders,and compromise theeffectiveness of therapeutic interventions;(5)the presence and of stigmatization and IWB should beAbbreviations:AACE,American Association of Clinical Endocrinology:ABCD.adiposity-based chronicdisease:BMI,body mass index:IWB.internalized weight bias;SDoH.social determinants of health:WC waist circumference.Address correspondence to the American Association of Clinical Endocrinology.7643 Gate Parkway.Suite 104-328.Jacksonville,FL32256.Email address:publications
