The Obesity Association, a division of the American Diabetes Association (ADA), has published the first chapters in their inaugural publication “Standards of Care in Overweight and Obesity”. This marks a new chapter for the American Diabetes Association, who, for over a decade, published their very popular “Standard of Care in Diabetes”. That publication includes a dedicated chapter on Obesity and Weight Management, however the new Standards of Care in Overweight and Obesity will expand significantly on the concepts and recommendations from that chapter. 

The first two chapters released are:

  • Introduction and Methodology
  • Weight Stigma and Bias

The introduction and methodology chapter sets the stage for the chapters that follow, and includes the scope, intended audience and inclusion criteria, methodology, grading, and other background information.

The weight stigma and bias chapter is the first chapter that includes graded recommendations. Key takeaways from that chapter include:

  • All staff should be trained on weight bias and stigma
  • Appropriate person-centered and weight sensitive care protocols should be implemented and communicated to staff
  • Weight-appropriate (usually 500 pounds or greater capacity) clinical equipment should be offered in the waiting room, exam room, and in other specialized service areas
  • Offer privacy during anthropometric measurements
  • Use appropriate, person-centered and nonjudgmental language when communicating (e.g., person with obesity vs. obese person)
  • Utilize shared decision making, when appropriate
  • Seek permission to discuss weight, and respect the answer if permission is not given

In addition to seven graded recommendations, there are also two figures and two tables, as well as a clinical practice checklist highlighting the minimum accommodations necessary to ensure that all individuals feel welcome in the healthcare environment. These minimum accommodations include things such as:

  • Ensuring there are sturdy chairs with ample spacing between each
  • Offering weight-sensitive media, including reading materials, art, etc.
  • Providing bariatric wheelchairs
  • Ensuring there is a weight-appropriate scale placed in a location that offers privacy
  • Providing exam room chairs and tables that are sturdy and weight appropriate
  • Offering large and extra large weight gowns and blood pressure cuffs, as well as appropriately long phlebotomy needles, and imaging systems that accommodate larger individuals
  • And in terms of weight limits, the goal should ideally by 500 pounds or greater

These represent the minimum requirements for all healthcare practices to reduce weight stigma. 

While the first two chapters were published earlier this week, we expect to see new chapters released in the following weeks and months. You can keep an eye on this page for news of updates. Those chapters will likely include important topics such as: BMI and similar measures of obesity, nutrition, physical activity, behavioral activity, pharmacotherapy (including GLP-1s), medical devices for weight loss, bariatric surgery and other metabolic surgeries, and more. We may even see this publication mimic the ADA Diabetes Standards of Care, or even the Obesity Medicine Association (OMA) Obesity Algorithm,  by receiving yearly updates.

Stay tuned for more updates as this manuscript evolves, and as new chapters are released. Let us know if you would like to see us cover this in more detail, including an updated Obesity Guidelines Side by Side comparing recommendations from the Obesity Association (ADA), OMA, AACE, or others. As always, thanks for reading, and we’ll see you for the next one!

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