The American Association of Clinical Endocrinology (AACE) recently released a consensus statement: Algorithm for the Evaluation and Treatment of Adults with Obesity/Adiposity-Based Chronic Disease (ABCD). Within the consensus statement, the ACCE outlines evidence-based guidance for clinicians in managing the complex, chronic disease that requires long-term care. 

The 2025 AACE consensus statement on obesity/adiposity-based chronic disease features eleven algorithms total, each of which we outline below. Each algorithm is designed to help guide clinicians in the decision-making process regarding the treatment of obesity/ABCD.

The algorithms are, in order of appearance in the consensus statement:

Principles of Person-Centered and Complication-Centric Management of Obesity/ABCD

  • Features nine principles developed by uniform consensus for person-centered care of adults with obesity/ABCD.

Care Model for People with Obesity/ABCD: Screening and Diagnosis

  • Screening and diagnosis involving both anthropometric and clinical components, which necessitates clinical evaluation and basic laboratory testing.

Diagnosis: Anthropometric Component

  • Criteria for the anthropometric component of the diagnosis using ethnic-specific cutoffs for BMI and adipose distribution.

Diagnosis: Clinical Component

  • The clinical component of the diagnosis and the staging of clinical severity based upon ABCD ORCD.

Individualized Treatment Plan, Therapeutic Goals, and Follow-Up

  • The use of disease staging in developing and implementing an individualized holistic treatment plan, establishing the clinical goals of therapy through shared decision making, and following up with appropriate treatment modifications based upon both the clinical response to therapy and a longer-term strategy for health maintenance.

Response to Therapy and Weight-Loss Targets for People with ABCD

  • The range of therapeutic weight-reduction goals generally needed to achieve desired clinical health outcomes in complication-centric care.

Behavioral/Lifestyle Therapy for People with Obesity/ABCD

  • Nonpharmacologic interventions involving nutrition, physical activity, and sleep, while reducing stress and implementing individualized behavioral therapy.

Hierarchies of Preferred Medications for Complication-Centric Care of People with ABCD (view algorithm)

  • Guidance to assist clinicians as they personalize therapy based on complication-centric care targeting specific ORCD.

Lower-Cost Pharmacologic Step Therapy for ABCD (view algorithm)

  • Guidance on switching to second-generation medication, if weight loss is insufficient in achieving clinical goals.

Medication for Obesity: Individualization of Therapy

  • Guidance to help individualize the choice of pharmacotherapy, taking into consideration ORCD, comorbidities, and potential adverse events, although the list of obesity-related conditions is not exhaustive.

Medications for Obesity Approved by the U.S. Food and Drug Administration

  • Information for prescribing obesity medications that are currently approved by the FDA for obesity (ie, “chronic weight management”), including considerations involving age, dose, titration, observed efficacy, cost, and cautions or contraindications.

Sign up for alerts and stay informed on the latest published guidelines and articles.

Copyright © 2025 Guideline Central, all rights reserved.