A new definition of obesity with co-morbid conditions--the first of its kind in the disease management community--provides the foundation for a developing Disease Management Association of America (DMAA) project that responds to the increasing prevalence of overweight and obesity in America.

The five-page definition document, with substantial background and literature citations, represents the first in a series of work products from the DMAA Obesity with Co-Morbidities Initiative, which the association launched last year under a grant from sanofi-aventis. The definition will be published in an upcoming second edition of DMAA's "Dictionary of Disease Management Terminology." The revised edition is expected this summer.

The initiative seeks to define and expand understanding of co-morbid obesity; lead development and encourage adoption of best practices for managing the condition; and promote health outcomes research. Other planned work products of the initiative include a collection of article submissions to Disease Management, DMAA's peer-reviewed journal; creation of an online resource center; and an Obesity Management Summit at DMAA's 2006 Disease Management Leadership Forum, Dec. 3 to 5, in Denver.

"There's no question that obesity, and the many diseases associated with it, present a looming national health crisis," says Donald E. Fetterolf, MD, chair of the DMAA Obesity with Co-Morbidities Steering Committee, which is overseeing the initiative. "As an organization that represents all aspects of disease management, we recognize the need to be at the forefront of the management of obesity as a chronic illness."

The definition notes that 64 percent of Americans 20 and older are overweight, and 30 percent are obese. Moreover, 15 percent of school-age children are overweight, with even higher rates within some ethnic groups. In all, 97 million U.S. adults are overweight or obese, and many exhibit pre-diabetes and other co-morbid conditions, the DMAA definition states.

"The concept of obesity and obesity with associated co-morbidities as manageable, chronic conditions is emerging," the definition states. "Robust epidemiological and scientific evidence clearly demonstrates that obesity should be considered in the context of chronic disease." Disease management "proactively interfaces" with other chronic diseases common in obese individuals, and "[b]y recognizing the central role that obesity plays in development of these illnesses, better care can result," the definition concludes.

The definition states that being overweight or obese "substantially increases the risk of chronic conditions and illnesses," such as hypertension, type 2 diabetes, coronary artery disease and stroke, as well as cancers of the endometrium, breast, prostate and colon. It incorporates the commonly accepted clinical definition of obesity: a body-mass index of greater than 30 and waist circumference of 40 inches or more for men and 35 inches or more for women.

The Dec. 3 Obesity Management Summit will focus on programs that have successfully helped participants to manage obesity through a variety of methods. DMAA has issued a call for abstracts for the summit and will accept proposals online through June 16. The online abstract submission system may be accessed through the DMLF Web site, at
dmaa.org/DMLF06

The complete DMAA Obesity with Co-Morbidities definition document may be viewed at:
dmaa.org/PDFs/Obesity_Definition.pdf

About DMAA

DMAA is a non-profit, voluntary membership association representing all stakeholders in disease management and care coordination. Through advocacy targeting the health care industry, government agencies, employers and the general public, DMAA promotes the important role disease management and care coordination play in improving care quality and outcomes for people with chronic conditions.

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