Non-dieting Approaches To Treatment Of Obesity

Department

Medicine

Document Type

Book Chapter

Publication Title

StatPearls [Internet]

Abstract

A body mass index of ≥30 (>27 in those of Asian descent) kilograms per square meter constitutes the definition of obesity. Obesity involves a complex interplay of genetic, sociocultural, environmental, and behavioral factors. In 1997, the World Health Organization (WHO) declared obesity a major global health issue along with undernutrition and climate change-the triad being termed "the Global Syndemic." Today in the United States of America (USA), one-third of the adult population is obese, with the Center for Disease Control projecting that by 2050 60% of men and 40% of women in the USA will be obese.

Obesity once again came into focus during the SARS-CoV-2 pandemic, when patients with obesity were found to have an increased need for mechanical ventilation and higher mortality. Once thought to be an exclusive problem of the developed world, numerous studies have shown developing countries now have the highest incidence of obesity. South-East Asians have a higher percentage of body fat, truncal/central obesity, and insulin resistance than their White race counterparts prompting the WHO to endorse a lower cut-off point for action against obesity at ≥27kg/m^2 in the Asian population. The latest terminology introduced for obesity is ABCD-adiposity based chronic disease, which shifts the focus to the chronic nature of obesity and its comorbidities, which require treatment in addition to the treatment of obesity itself.

It is well known that obesity is associated with a shortened life span and increased incidence of obstructive sleep apnea, osteoarthritis, gout, polycystic ovarian syndrome, metabolic syndrome, prediabetes, hypertension, stroke, non-alcoholic fatty liver disease, heart failure, and cancers of the colon, breast, endometrium, and gallbladder. Thus the treatment of obesity is essential, along with early identification of complications. Although this article focuses on non-dieting approaches to treating obesity with medications, gastrointestinal devices, and bariatric surgery, it must be emphasized that diet and exercise are essential to good cardiometabolic health in obese patients.

Publication Date

9-28-2021

Publisher

StatPearls Publishing

PubMed ID

34283495

Link to Full Text

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