ARS | Publication request: Obesity management

Submitted to: Springer Verlag
Publication Type: Book / Chapter
Publication Acceptance Date: January 1, 2011
Publication Date: January 1, 2011
Citation: Johnston, C.A., Foreyt, J.P. 2011. Obesity management. In: Grundy, S.M., editor. Atlas of Atherosclerosis and Metabolic Syndrome. Philadelphia: Current Medicine, Springer. p. 207-225.

Technical Abstract: Rates of obesity in the United States have increased dramatically over the past 30 years. Approximately 35% of children and 66% of adults are currently considered overweight or obese. Although obesity is seen in all ethnicities and economic classes, ethnic minorities and those of lower socioeconomic status disproportionately have obesity and its related morbidities. Not only are the rates of obesity high, the increase in prevalence continues to steadily climb. Although overweight and obesity have become public health risks in the United States, it has become clear that obesity is a global issue affecting both developed and developing countries. Overweight and obesity correspond with higher rates of related disease. Health consequences include type 2 diabetes, hypertension, stroke, coronary heart disease, osteoarthritis, sleep apnea, respiratory issues, and some types of cancer (e.g., breast, prostate, colon). Higher body mass indices also are associated with an increase in all-cause mortality. Although the health consequences of obesity are most severe in adults, children are experiencing what were previously though of as adult morbidities, such as type 2 diabetes, hypertension, and dyslipidemia. The causes of obesity are clearly multifactorial. Although the major determinants of obesity are highly debated, most agree that this disease is a combination of genetic, physiological, social, environmental, and behavioral factors. The multiple determinants of obesity increase the difficulty of treating this disease. However, given its high prevalence and incidence, the need to identify effective prevention and treatment strategies is clear. Initial treatment goals are typically 10% weigh loss, as this amount has been shown to have significant health improvements. A reasonable timeframe for this amount of weight loss is about 6 months. Multiple efforts have been made to address the obesity epidemic in terms of both treatment and prevention, including advances in diet and physical activity; interventions involving families, schools, and communities; pharmacotherapy; and surgery. Despite such efforts, the increasing prevalence and degree of overweight continues to increase.