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Obese comorbidities include diabetes mellitus, hypertension, dyslipidemia and sleep apnea.
Obese comorbidities include diabetes mellitus, hypertension, dyslipidemia and sleep apnea. -- Posted by Sweet Zombie Jesus! on 06-06-05 06:40
The prevalence of overweight and obesity is increasing worldwide.
During the last two decades, the prevalence of adults in the higher
body mass index (BMI) categories in the US has increased the most, as
much as 300% for those with a BMI above 40kg/m2. In children and
adolescents, a doubling of the prevalence of severe overweight poses a
serious health risk to future generations of young adults who may
develop chronic diseases normally associated with aging. The simple
definition of obesity, an imbalance between energy intake and energy
expenditure, ignores the complexity of, and largely unknown
interactions between, genes, food intake and physical activity, which
together determine bodyweight and fat distribution.
Although the etiology and manifestations of overweight and obesity are
complex, the assessment of overweight and obesity requires only an
accurate measurement of bodyweight, height and abdominal circumference,
as well as a history and physical examination attuned to the
morbidities that commonly accompany overweight and obesity such as
diabetes mellitus, hypertension, dyslipidemia and sleep apnea. The
treatment of patients with overweight and obesity continues to be based
on changes to diet and physical activity. Simple behavior modification
techniques are within the reach of busy clinicians.
The additional use of available bodyweight reduction medications can
reliably lead to a 5 to 10% reduction from initial bodyweight, a loss
that has been shown to provide significant health benefit. The use of
meal replacements has also been shown to be effective and is probably
an under-appreciated treatment resource. Surgery is the most successful
treatment for those with severe obesity and should be discussed as an
option for those in the appropriate bodyweight categories.
Because societal trends favor the greater intake of calorie-dense foods
and less physical activity to accomplish the activities of daily life,
the future of obesity treatment will require the development of
bodyweight reduction medications that work by a variety of mechanisms
to decrease food intake or increase energy expenditure. Such
medications should not be viewed as a 'crutch' but rather as a 'helping
hand' that enable people to better adhere to a healthier lifestyle.
Treat Endocrinol. 2002;1(1):21-36. Strategies for the management of
patients with obesity.Hamilton M.Pennington Biomedical Research Center,
Baton Rouge, Louisiana 70808, USA. hamiltma@pbrc.edu
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