ABSTRACT
Adiposity-based chronic disease (ABCD) is a novel diagnostic term that emphasizes dysfunctional adipose tissue that is present in an unfavorable distribution and associated with metabolic disease, cardiovascular risk, and a host of other comorbidities. The health consequences of ABCD are far-reaching and include metabolic, cardiovascular, orthopedic, gastrointestinal, psychiatric, and oncologic risk. Many ABCD-associated complications instigate adverse lifestyle choices and create vicious cycles of abnormal adiposity. All patients with ABCD should strive for a healthy lifestyle, avoiding or minimizing modern conveniences and living practices that are detrimental to metabolic health. The human response to chronic stress is associated with ABCD and involves hypothalamic dysfunction, increased consumption of palatable and calorie-dense foods, and reduced physical activity. Modalities to address stress and activities to lessen pathophysiologic effects of stress may be beneficial in ABCD. Antibiotic use can affect microflora residing within the gastrointestinal tract serving as an exemplar of how other lifestyle changes that affect gut microbiota can indirectly lead to ABCD.
