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AACE guidelines: Timothy Garvey, MD, FACE; Jeffrey I. Mechanick, MD, FACP, FACE, FACN, ECNU; Elise M. Brett, MD, FACE, CNSC, ECNU; Alan J. Garber, MD, PhD, FACE; Daniel L. Hurley, MD, FACE; Ania M. Jastreboff, MD, PhD; Karl Nadolsky, DO; Rachel Pessah-Pollack, MD; Raymond Plodkowski, MD; and Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines

Adult OMA Obesity guidelines:

Obesity Algorithm®

Bays HE, McCarthy W, Christensen S, Tondt J, Karjoo S, Davisson L, Ng J, Golden A, Burridge K, Conroy R, Wells S, Umashanker D, Afreen S, DeJesus R, Salter D, Shah N, Richardson L. Obesity Algorithm eBook, presented by the Obesity Medicine Association. 2020.

Exercise – ACSM guidelines

Obesity Management – ACC/AHA/TOS guidelines: Michael D. Jensen, Donna H. Ryan, Caroline M. Apovian, Jamy D. Ard, Anthony G. Comuzzie, Karen A. Donato, Frank B. Hu, Van S. Hubbard, John M. Jakicic, Robert F. Kushner, Catherine M. Loria, Barbara E. Millen, Cathy A. Nonas, F. Xavier Pi-Sunyer, June Stevens, Victor J. Stevens, Thomas A. Wadden, Bruce M. Wolfe, Susan Z. Yanovski

Pediatric Obesity—Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline: Dennis M. Styne, Silva A. Arslanian, Ellen L. Connor, Ismaa Sadaf Farooqi, M. Hassan Murad, Janet H. Silverstein, Jack A. Yanovski. J Clin Endocrinol Metab (2017) 102 (3): 709-757.

Pediatric OMA guidelines:

Pediatric Obesity Algorithm®

Cuda S, Censani M, Joseph M, Browne N, O’Hara V. Pediatric Obesity Algorithm, presented by the Obesity Medicine Association. 2018-2020.


Pharmacotherapy – Endocrine Society Pharmacologic Management of Obesity guidelines: Caroline M. Apovian Louis J. Aronne Daniel H. Bessesen Marie E. McDonnell M. Hassan Murad Uberto Pagotto Donna H. Ryan Christopher D. Still

Surgery – AACE/TOS/ASMBS Guidelines 2013: Jeffrey I. Mechanick, M.D., Adrienne Youdim, M.D., Daniel B. Jones, M.D., M.S.,W., Timothy Garvey, M.D., Daniel L. Hurley, M.D., M. Molly McMahon, M.D., Leslie J. Heinberg, Ph.D., Robert Kushner, M.D., Ted D. Adams, Ph.D., M.P.H., Scott Shikora, M.D., John B. Dixon, M.B.B.S., Ph.D., Stacy Brethauer, M.D.

The USPSTF Pediatric Guidelines (June 2017)


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1. Clinical Practice Guidelines We Can Trust 2011

Chronic Disease of Obesity

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3. Jastreboff AM, Kotz CM, Kahan S, et al.: Obesity as a Disease: The Obesity Society 2018 Position Statement. Obesity (Silver Spring) 2019 27:7-9.

4. Bays H: Adiposopathy, “sick fat,” Ockham’s razor, and resolution of the obesity paradox. Curr Atheroscler Rep 2014 16:409.

5. Hales CM, Carroll MD, Fryar CD, et al.: Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. NCHS Data Brief 2017 1-8.

6. Fryar CD, Kruszon-Moran D, Gu Q, et al.: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics Mean Body Weight, Height, Waist Circumference, and Body Mass Index Among Adults: United States, 1999–2000 Through 2015–2016. National Health Statistics Reports 2018 Number 122:1 - 16.

7. Puhl R, Peterson JL, Luedicke J: Motivating or stigmatizing? Public perceptions of weight-related language used by health providers. Int J Obes (Lond) 2013 37:612-619.

8. Ravussin E, Ryan D: Response to “The need for people-first language in our Obesity journal”. Obesity (Silver Spring) 2015 23:918.

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12. Bays H, Scinta W: Adiposopathy and epigenetics: an introduction to obesity as a transgenerational disease. Curr Med Res Opin 2015 31:2059-2069.


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19. Curley JP, Mashoodh R, Champagne FA: Epigenetics and the origins of paternal effects. Horm Behav 2011 59:306-314.

20. Bays HE: “Sick fat,” metabolic disease, and atherosclerosis. Am J Med 2009 122:S26-37.

21. Bays HE: Adiposopathy is “sick fat” a cardiovascular disease? J Am Coll Cardiol 2011 57:2461-2473.

22. Bays HE: Adiposopathy, diabetes mellitus, and primary prevention of atherosclerotic coronary artery disease: treating “sick fat” through improving fat function with antidiabetes therapies. Am J Cardiol 2012 110:4B-12B.

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Obesity Classification

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26. Banack HR, Wactawski-Wende J, Hovey KM, et al.: Is BMI a valid measure of obesity in postmenopausal women? Menopause 2017

27. Hsu WC, Araneta MR, Kanaya AM, et al.: BMI cut points to identify at-risk Asian Americans for type 2 diabetes screening. Diabetes Care 2015 38:150-158.

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31. Bays H: Central obesity as a clinical marker of adiposopathy; increased visceral adiposity as a surrogate marker for global fat dysfunction. Curr Opin Endocrinol Diabetes Obes 2014 21:345-351.

32. Carroll JF, Chiapa AL, Rodriquez M, et al.: Visceral fat, waist circumference, and BMI: impact of race/ethnicity. Obesity (Silver Spring) 2008 16:600-607.

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39. Grundy SM, Neeland IJ, Turer AT, et al.: Waist circumference as measure of abdominal fat compartments. J Obes 2013 2013:454285.

40. Camhi SM, Bray GA, Bouchard C, et al.: The relationship of waist circumference and BMI to visceral, subcutaneous, and total body fat: sex and race differences. Obesity (Silver Spring) 2011 19:402-408.

Fat Mass Disease

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43. Bays HE: Current and investigational antiobesity agents and obesity therapeutic treatment targets. Obes Res 2004 12:1197-1211.

44. Pearl RL, Wadden TA, Hopkins CM, et al.: Association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity. Obesity (Silver Spring) 2017 25:317-322.

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48. Gileles-Hillel A, Kheirandish-Gozal L, Gozal D: Biological plausibility linking sleep apnoea and metabolic dysfunction. Nat Rev Endocrinol 2016 12:290-298.

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50. Weaver TE, Calik MW, Farabi SS, et al.: Innovative treatments for adults with obstructive sleep apnea. Nat Sci Sleep 2014 6:137-147.

Adiposopathy (Sick Fat Disease)

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54. Bays HE, Gonzalez-Campoy JM, Henry RR, et al.: Is adiposopathy (sick fat) an endocrine disease? Int J Clin Pract 2008 62:1474-1483.

55. Bays HE, Gonzalez-Campoy JM, Bray GA, et al.: Pathogenic potential of adipose tissue and metabolic consequences of adipocyte hypertrophy and increased visceral adiposity. Expert Rev Cardiovasc Ther 2008 6:343-368.

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61. Lim SS, Norman RJ, Davies MJ, et al.: The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Rev 2013 14:95-109.

62. Bays HE, Gonzalez-Campoy JM, Schorr AB: What men should know about metabolic syndrome, adiposopathy and ‘sick fat’. Int J Clin Pract 2010 64:1735-1739.

63. Chetrite GS, Feve B: Preface to special issue on: Adiposopathy in Cancer and (Cardio)Metabolic Diseases: an Endocrine Approach - Part 4. Horm Mol Biol Clin Investig 2015 23:1-4.

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65. Hursting SD, Dunlap SM: Obesity, metabolic dysregulation, and cancer: a growing concern and an inflammatory (and microenvironmental) issue. Ann N Y Acad Sci 2012 1271:82-87.

66. Whiteman DC, Wilson LF: The fractions of cancer attributable to modifiable factors: A global review. Cancer Epidemiol 2016 44:203-221.

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68. Steele CB, Thomas CC, Henley SJ, et al.: Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity - United States, 2005-2014. MMWR Morb Mortal Wkly Rep 2017 66:1052-1058.

69. Subak LL, Richter HE, Hunskaar S: Obesity and urinary incontinence: epidemiology and clinical research update. J Urol 2009 182:S2-7.

70. Kudish BI, Iglesia CB, Sokol RJ, et al.: Effect of weight change on natural history of pelvic organ prolapse. Obstet Gynecol 2009 113:81-88.

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73. Pasquali R, Patton L, Gambineri A: Obesity and infertility. Curr Opin Endocrinol Diabetes Obes 2007 14:482-487.

74. Yu Z, Han S, Zhu J, et al.: Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: asystematic review and meta-analysis. PLoS One 2013 8:e61627.

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Obesity Paradox

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77. Akin I, Nienaber CA: “Obesity paradox” in coronary artery disease. World J Cardiol 2015 7:603-608.

78. Yu E, Ley SH, Manson JE, et al.: Weight History and All-Cause and Cause-Specific Mortality in Three Prospective Cohort Studies. Ann Intern Med 2017 166:613-620.

79. Caleyachetty R, Thomas GN, Toulis KA, et al.: Metabolically Healthy Obese and Incident Cardiovascular Disease Events Among 3.5 Million Men and Women. J Am Coll Cardiol 2017 70:1429-1437.

80. Chang VW, Langa KM, Weir D, et al.: The obesity paradox and incident cardiovascular disease: A population-based study. PLoS One 2017 12:e0188636.

81. Bhaskaran K, Dos-Santos-Silva I, Leon DA, et al.: Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3.6 million adults in the UK. Lancet Diabetes Endocrinol 2018 6:944-953.

82. Khan SS, Ning H, Wilkins JT, et al.: Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity. JAMA Cardiol 2018 3:280-287.

83. Wade KH, Carslake D, Sattar N, et al.: BMI and Mortality in UK Biobank: Revised Estimates Using Mendelian Randomization. Obesity (Silver Spring) 2018 26:1796-1806.

84. Iliodromiti S, Celis-Morales CA, Lyall DM, et al.: The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. Eur Heart J 2018 39:1514-1520.

85. Jung CH, Lee WJ, Song KH: Metabolically healthy obesity: a friend or foe? Korean J Intern Med 2017 32:611-621.

86. Mongraw-Chaffin M, Foster MC, Kalyani RR, et al.: Obesity Severity and Duration Are Associated With Incident Metabolic Syndrome: Evidence Against Metabolically Healthy Obesity From the Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab 2016 101:4117-4124.

87. Lavie CJ, Laddu D, Arena R, et al.: Healthy Weight and Obesity Prevention: JACC Health Promotion Series. J Am Coll Cardiol 2018 72:1506-1531.

88. Guo F, Garvey WT: Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults. Obesity (Silver Spring) 2016 24:516-525.

89. Kuk JL, Rotondi M, Sui X, et al.: Individuals with obesity but no other metabolic risk factors are not at significantly elevated allcause mortality risk in men and women. Clin Obes 2018 8:305-312.

90. Schulze MB: Metabolic health in normal-weight and obese individuals. Diabetologia 2018

91. Gavrilova O, Marcus-Samuels B, Graham D, et al.: Surgical implantation of adipose tissue reverses diabetes in lipoatrophic mice. J Clin Invest 2000 105:271-278.

92. Klein S, Fontana L, Young VL, et al.: Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 2004 350:2549-2557.

93. Steele L, Lloyd A, Fotheringham J, et al.: A retrospective cross-sectional study on the association between tobacco smoking and incidence of ST-segment elevation myocardial infarction and cardiovascular risk factors. Postgrad Med J 2015 91:492-496.

94. Rallidis LS, Triantafyllis AS, Tsirebolos G, et al.: Prevalence of heterozygous familial hypercholesterolaemia and its impact on longterm prognosis in patients with very early ST-segment elevation myocardial infarction in the era of statins. Atherosclerosis 2016 249:17-21.

95. Oesch L, Tatlisumak T, Arnold M, et al.: Obesity paradox in stroke - Myth or reality? A systematic review. PLoS One 2017 12:e0171334.

96. Zhi G, Xin W, Ying W, et al.: “Obesity Paradox” in Acute Respiratory Distress Syndrome: Asystematic Review and Meta-Analysis. PLoS One 2016 11:e0163677.

97. Park J, Ahmadi SF, Streja E, et al.: Obesity paradox in end-stage kidney disease patients. Prog Cardiovasc Dis 2014 56:415-425.

98. Panwar B, Hanks LJ, Tanner RM, et al.: Obesity, metabolic health, and the risk of end-stage renal disease. Kidney Int 2015 87:1216-1222.

99. Niederdeppe J, Roh S, Shapiro MA: Acknowledging individual responsibility while emphasizing social determinants in narratives to promote obesity-reducing public policy: a randomized experiment. PLoS One 2015 10:e0117565.

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Stress and Obesity

100. Harrell CS, Gillespie CF, Neigh GN: Energetic stress: The reciprocal relationship between energy availability and the stress response. Physiol Behav 2016 166:43-55.

101. Yau YH, Potenza MN: Stress and eating behaviors. Minerva Endocrinol 2013 38:255-267.

102. Thaler JP, Guyenet SJ, Dorfman MD, et al.: Hypothalamic inflammation: marker or mechanism of obesity pathogenesis? Diabetes 2013 62:2629-2634.

103. Moore CJ, Cunningham SA: Social position, psychological stress, and obesity: a systematic review. J Acad Nutr Diet 2012 112:518-526.

104. Jackson SE, Kirschbaum C, Steptoe A: Hair cortisol and adiposity in a population-based sample of 2,527 men and women aged 54 to 87 years. Obesity (Silver Spring) 2017 25:539-544.

105. Geer EB, Lalazar Y, Couto LM, et al.: A prospective study of appetite and food craving in 30 patients with Cushing’s disease. Pituitary 2016 19:117-126.

106. Capuron L, Lasselin J, Castanon N: Role of Adiposity-Driven Inflammation in Depressive Morbidity. Neuropsychopharmacology 201742:115-128.

107. Nishitani N, Sakakibara H: Association of psychological stress response of fatigue with white blood cell count in male daytime workers. Ind Health 2014 52:531-534.

108. McGregor BA, Murphy KM, Albano DL, et al.: Stress, cortisol, and B lymphocytes: a novel approach to understanding academic stress and immune function. Stress 2016 19:185-191.

Patient History

109. Nesbitt S, Palomarez RE: Review: Increasing Awareness and Education on Health Disparities for Health Care Providers. Ethn Dis 2016 26:181-190.

110. Rusin M, Arsand E, Hartvigsen G: Functionalities and input methods for recording food intake: a systematic review. Int J Med Inform 2013 82:653-664.

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451. Kosiborod M, Lam CSP, Kohsaka S, et al.: Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL 2 Study. J Am Coll Cardiol 2018 71:2628-2639.

452. Home P: Cardiovascular outcome trials of glucose-lowering medications: an update. Diabetologia 2019

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455. Bohula EA, Scirica BM, Inzucchi SE, et al.: Effect of lorcaserin on prevention and remission of type 2 diabetes in overweight and obese patients (CAMELLIA-TIMI 61): a randomised, placebo-controlled trial. Lancet 2018 392:2269-2279.

456. Bays H, Perdomo C, Nikonova E, et al.: Lorcaserin and metabolic disease: weight-loss dependent and independent effects. Obes Sci Pract 2018 4:499-505.

457. Scirica BM, Bohula EA, Dwyer JP, et al.: Lorcaserin and Renal Outcomes in Obese and Overweight Patients in the CAMELLIA-TIMI 61 Trial. Circulation 2018

458. Gadde KM, Martin CK, Berthoud HR, et al.: Obesity: Pathophysiology and Management. J Am Coll Cardiol 2018 71:69-84.

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460. Das SR, Everett BM, Birtcher KK, et al.: 2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol 2018 72:3200-3223.

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462. Sanches Machado d’Almeida K, Ronchi Spillere S, Zuchinali P, et al.: Mediterranean Diet and Other Dietary Patterns in Primary Prevention of Heart Failure and Changes in Cardiac Function Markers: A Systematic Review. Nutrients 2018 10:

463. Jorsal A, Kistorp C, Holmager P, et al.: Effect of liraglutide, a glucagon-like peptide-1 analogue, on left ventricular function in stable chronic heart failure patients with and without diabetes (LIVE)-a multicentre, double-blind, randomised, placebo-controlled trial. Eur J Heart Fail 2017 19:69-77.

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468. Vorsanger MH, Subramanyam P, Weintraub HS, et al.: Cardiovascular Effects of the New Weight Loss Agents. J Am Coll Cardiol 2016 68:849-859.

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495. Hsu PF, Sung SH, Cheng HM, et al.: Cardiovascular Benefits of Acarbose vs Sulfonylureas in Patients With Type 2 Diabetes Treated With Metformin. J Clin Endocrinol Metab 2018 103:3611-3619.

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497. O’Brien MJ, Karam SL, Wallia A, et al.: Association of Second-line Antidiabetic Medications With Cardiovascular Events Among Insured Adults With Type 2 Diabetes. JAMA Netw Open 2018 1:e186125.

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Obesity and High Blood Pressure

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Obesity and Dyslipidemia

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Obesity and Non-alcoholic Fatty Liver Disease (NAFLD)

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Obesity and Cancer

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