Understanding ABCD

Adiposity-Based Chronic Disease (ABCD) is a paradigm shift in how we classify, diagnose, and manage patients with adiposity-related health complications.

What is ABCD?

ABCD stands for Adiposity-Based Chronic Disease. It's a diagnostic framework that replaces "obesity" with a focus on metabolic dysfunction rather than body mass index alone.

The framework recognizes that not all people with excess body fat have metabolic complications, and conversely, some people with relatively normal weight still have significant metabolic dysfunction (metabolically unhealthy normal weight).

ABCD divides adiposity-related disease into four stages based on the type and severity of complications, allowing clinicians to deliver more targeted, evidence-based care.

ABCD Framework Breakdown

  • AAdiposity-Based - Focused on fat pathophysiology
  • BBased on - Built on scientific evidence
  • CChronic - Long-term metabolic disease
  • DDisease - Requiring medical management

Core Principles of ABCD

Beyond BMI

ABCD moves away from BMI-centric approaches to focus on actual pathophysiological complications and metabolic dysfunction.

Complication-Centric

The framework classifies disease severity based on the presence and magnitude of adiposity-related complications.

Multisystem Approach

ABCD evaluates metabolic, biomechanical, cardiovascular, and psychological complications comprehensively.

Evidence-Based

Built on rigorous clinical research and validated biomarkers for accurate disease assessment and monitoring.

Why ABCD Matters

Approach:Traditional obesity classification using BMI alone
Limitation:BMI doesn't distinguish between patients with and without complications
Solution:ABCD creates a dynamic framework that reflects actual disease burden
Approach:Inconsistent screening and diagnosis
Limitation:Different healthcare systems use different criteria for identifying at-risk patients
Solution:ABCD provides standardized diagnostic criteria and staging system
Approach:One-size-fits-all treatment approaches
Limitation:Patients with same BMI may have completely different metabolic profiles
Solution:ABCD enables personalized treatment based on specific complications
Approach:Fragmented care across specialties
Limitation:Patients see multiple specialists without coordinated management
Solution:ABCD framework facilitates integrated multidisciplinary care

The Four Stages of ABCD

Stage 1

At Risk

Primary Prevention

Stage 2

Mild/Moderate

Secondary Prevention

Stage 3

Established

Active Management

Stage 4

Advanced

Tertiary Intervention

Explore All Stages →

Systemic Impact

ABCD recognizes that adiposity affects multiple organ systems simultaneously. The disease is classified by the presence and severity of complications across four critical health domains:

Metabolic

  • Type 2 Diabetes
  • Dyslipidemia
  • NAFLD
  • Insulin Resistance

Biomechanical

  • Sleep Apnea
  • Osteoarthritis
  • GERD
  • Urinary Issues

Cardiovascular

  • Hypertension
  • Heart Failure
  • CAD
  • Arrhythmias

Psychological

  • Depression
  • Anxiety
  • Body Image Issues
  • Stigma
View Complications →