Obesity is a chronic disease and should be treated as such, according to new evidence-based guidelines for treating obesity from the American Association of Clinical Endocrinologists (AACE).  The guidelines are a first for AACE.  The association first recognized obesity as a disease in 2012, and past efforts to help doctors treat it included an algorithm and a “framework.”  They were not evidence-based: “Rather, they were the consensus of a small group of experts.” 

"The thrust of the final recommendations is to recognize that obesity is a complex, adiposity-based chronic disease, where management targets both weight-related complications and adiposity to improve overall health and quality of life," wrote the authors. The guidelines were an attempt to answer nine pragmatic and clinical questions about treating obesity like who should be treated and how diagnoses should be made.

The guidelines don’t rely on body mass index (BMI) alone, but do incorporate waist circumference and other measures to improve accuracy.  Physicians can then use that data from screening to determine individual treatment plans including options. The screening process was designed to be easy and straightforward.  About 85% of the evidence used in the guidelines was rated as high quality. The guidelines don't, however, recommend or endorse any specific diet, just a reduction of calories.

The pharmacological aspect is “the engine of the guidelines”, according to committee co-chair, obesity is a clinical disease.  The individualization of pharmacotherapy is a big advantage of the guidelines, and that they will be updated as new data come in. “This is truly a holistic guideline and algorithm that we put together, and that’s how medicine should be -- it should be holistic, that's what we are supposed to do, and obesity is the quintessential holistic disease."

Source:  http://www.medpagetoday.com/MeetingCoverage/AACE/58201