Fitch Angela K, Bays Harold E
Massachusetts General Hospital Weight Center, Harvard Medical School, 50 Staniford Street Suite 430, Boston, MA, 02114, USA.
Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA.
Obes Pillars. 2022 Jan 15;1:100004. doi: 10.1016/j.obpill.2021.100004. eCollection 2022 Mar.
The Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) regarding definition, diagnosis, bias, standard operating procedures (SOPs) and telehealth is intended to provide clinicians an overview of obesity medicine and provide basic organizational tools towards establishing, directing, managing, and maintaining an obesity medical practice.
This CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by Obesity Medicine Association leadership.
OMA has defined obesity as: "A chronic, progressive, relapsing, and treatable multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences." While body mass index may be sufficiently diagnostic for populations and many patients, accurate diagnosis of adiposity in an individual may require anthropometric assessments beyond body weight alone (e.g., waist circumference, percent body fat, and android/visceral fat). Obesity complications can be categorized as "sick fat disease" (adiposopathy) and/or "fat mass disease." Obesity complications predominantly of fat mass origins include sleep apnea and orthopedic conditions. Obesity complications due to adiposopathic endocrinopathies and/or immunopathies include cardiovascular disease, cancer, elevated blood sugar, elevated blood pressure, dyslipidemia, fatty liver, and alterations in sex hormones in both males (i.e., hypogonadism) and females (i.e., polycystic ovary syndrome). Obesity treatment begins with proactive steps to avoid weight bias, including patient-appropriate language, office equipment, and supplies. To help manage obesity and its complications, this CPS provides a practical template for an obesity medicine practice, creation of standard operating procedures, and incorporation of the OMA "ADAPT" method in telehealth (ssessment, iagnosis, dvice, rognosis, and reatment).
The OMA CPS regarding "Obesity Definition, Diagnosis, Bias, Standard Operating Procedures (SOPs), and Telehealth" is one in a series of OMA CPSs designed to assist clinicians care for patients with the disease of obesity.
肥胖医学协会（OMA）关于定义、诊断、偏见、标准操作程序（SOP）和远程医疗的临床实践声明（CPS）旨在为临床医生提供肥胖医学概述，并提供基本的组织工具，以建立、指导、管理和维持肥胖医学实践。
本CPS基于已发表的科学文献引用、OMA作者的临床观点以及肥胖医学协会领导层的同行评审。
OMA将肥胖定义为：“一种慢性、进行性、复发性且可治疗的多因素神经行为疾病，其中体脂增加会促进脂肪组织功能障碍和异常脂肪量的物理作用力，从而导致不良的代谢、生物力学和社会心理健康后果。”虽然体重指数对于群体和许多患者可能足以用于诊断，但个体肥胖的准确诊断可能需要除体重之外的人体测量评估（例如腰围、体脂百分比以及腹部/内脏脂肪）。肥胖并发症可分为“病态脂肪疾病”（脂肪病）和/或“脂肪量疾病”。主要源于脂肪量的肥胖并发症包括睡眠呼吸暂停和骨科疾病。由脂肪病性内分泌病和/或免疫病引起的肥胖并发症包括心血管疾病、癌症、血糖升高、血压升高、血脂异常、脂肪肝以及男性（即性腺功能减退）和女性（即多囊卵巢综合征）性激素的改变。肥胖治疗始于采取积极措施避免体重偏见，包括使用适合患者的语言、办公设备和用品。为帮助管理肥胖及其并发症，本CPS提供了一个肥胖医学实践的实用模板、标准操作程序的创建以及在远程医疗中纳入OMA的“ADAPT”方法（评估、诊断、建议、预后和治疗）。
OMA关于“肥胖定义、诊断、偏见、标准操作程序（SOP）和远程医疗”的CPS是OMA一系列CPS中的一份，旨在协助临床医生护理肥胖症患者。
