AIMS/HYPOTHESIS: The need for understanding obesity as a chronic disease, its stigmatization, and the lack of actionability related to it demands a new approach. The adiposity-based chronic disease (ABCD) model is based on adiposity amount, distribution, and function, with a three stage complication-centric rather than a body mass index (BMI)-centric approach. The prevalence rates and associated risk factors are presented. METHODS: In total, 2159 participants were randomly selected from Czechia. ABCD was established as BMI ≥ 25 kg/m2 or high body fat percent, or abdominal obesity and then categorized by their adiposity-based complications: Stage 0: none; Stage 1: mild/moderate; Stage 2: severe. RESULTS: ABCD prevalence was 62.8%. Stage 0 was 2.3%; Stage 1 was 31.4%; Stage 2 was 29.1%. Comparing with other classifiers, participants in Stage 2 were more likely to have diabetes, hypertension, and metabolic syndrome than those with overweight, obesity, abdominal obesity, and increased fat mass. ABCD showed the highest sensitivity and specificity to detect participants with peripheral artery disease, increased intima media, and vascular disease. CONCLUSION/INTERPRETATION: The ABCD model provides a more sensitive approach that facilitates the early detection and stratification of participants at risk compared to traditional classifiers.

Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA

Department of Global Health and Population Harvard TH Chan School of Public Health Harvard University Boston Massachusetts USA

Department of Internal Medicine 2nd Faculty of Medicine Charles University Praha Praha Czech Republic

Department of Medicine 2 3rd Faculty of Medicine Charles University and Královské Vinohrady University Hospital Prague Czech Republic

Department of Medicine University of Padova Padova Italy

Department of Public Health Faculty of Medicine Masaryk University Brno Czech Republic

European Association for the Study of Obesity Teddington Middlesex UK

Foundation for Clinic Public Health and Epidemiological Research of Venezuela Caracas Venezuela

International Clinical Research Center Brno Brno Czech Republic

LifeDoc Diabetes and Obesity Clinic Memphis Tennessee USA

The Marie Josée and Henry R Kravis Center for Cardiovascular Health at Mount Sinai Heart and Division of Endocrinology Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai New York New York USA

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