Proposal for a Scientifically Correct and Medically Actionable Disease Classification System (ICD) for Obesity

Objective Obesity is responsible for a huge burden of suffering and social costs, and yet many patients lack access to evidence‐based therapies. The diagnostic term “obesity” and inadequate International Classification of Diseases (ICD) codes contribute to suboptimal efforts to prevent and treat obesity as a chronic disease. The goal of this review is to develop a medically actionable classification system based on the diagnostic term “adiposity‐based chronic disease” (ABCD) that reflects disease pathophysiology and specific complications causing morbidity and mortality. Methods A coding system based on the diagnosis of ABCD with four domains is proposed: A codes reflect pathophysiology, B codes indicate BMI classification, C codes specify specific biomechanical and cardiovascular complications remediable by weight loss, and D codes indicate the degree of the severity of complications. Supplemental codes identify aggravating factors that complicate care and that are relevant to a personalized therapeutic plan. Results The coding system addresses pathophysiology and therapeutic goals and differential risk, presence, and severity of specific complications that are integral to ABCD as a chronic disease. Conclusions The scientifically correct and medically actionable approach to diagnosis and disease coding will lead to greater acknowledgement of ABCD as a disease and accessibility to evidence‐based therapies on behalf of patients across the life cycle.