### Addressing Weight Bias and Stigma in Diabetes Care Healthcare professionals should be aware of their own biases regarding patients' weight. The American Association of Clinical Endocrinology (AACE) has made recommendations to reduce weight bias and stigma. Weight bias involves negative ideas about excess body weight, while weight stigma includes discriminatory thoughts and actions towards people based on their weight and size. The AACE advises professionals to survey patients with obesity about internalized weight bias, which occurs when individuals feel negatively about themselves due to their weight. According to Dr. Karl Nadolsky from Michigan State University, acknowledging bias in all forms is crucial for both clinicians and patients. Internalized weight bias is a complication of obesity and contributes to its pathophysiology. The AACE's work dates back to 2012 when they proposed considering obesity as a chronic disease. In 2013, the American Medical Association adopted this idea. In 2017, the AACE introduced the term "adiposity-based chronic disease" (ABCD) to describe health complications linked to excess weight, such as heart disease, sleep apnea, and knee arthritis. Weight loss is used among other treatments to address these complications, not as an end goal. Dr. Nadolsky emphasizes shifting away from a weight-centric approach to a holistic focus on a person's health. For patients with complications like type 2 diabetes, sleep apnea, and knee arthritis, intensive medical therapy is more urgently needed. The new document aims to reduce stigma and bias and improve health outcomes. Internalized weight bias creates barriers to treatment and therapy success, forming a vicious cycle. The AACE recommends following the "5A’s" for obesity and ABCD: 1. **Ask**: Identify and assess the patient’s weight status. 2. **Advise**: Provide clear, evidence-based advice on weight management. 3. **Assess**: Determine the patient’s readiness to change. 4. **Assist**: Help the patient in setting realistic goals and provide support. 5. **Arrange**: Schedule follow-ups to monitor progress. Optimal outcomes for patients with ABCD require empowered, informed patients who partner with a prepared healthcare system that offers full access to evidence-based care.