Obesity in adults: Overview of management
- George A Bray, MD
George A Bray, MD
- Boyd Professor Emeritus, Pennington Biomedical Research Center/Louisiana State University
- Professor of Medicine Emeritus, Louisiana State University Health Science Center
- Leigh Perreault, MD
Leigh Perreault, MD
- Associate Professor of Medicine
- University of Colorado Anschutz Medical Campus
- Associate Professor of Epidemiology
- Colorado School of Public Health
- Section Editors
- F Xavier Pi-Sunyer, MD, MPH
F Xavier Pi-Sunyer, MD, MPH
- Section Editor — Obesity
- Professor of Medicine
- Columbia University College of Physicians and Surgeons
- Timothy O Lipman, MD
Timothy O Lipman, MD
- Section Editor — Nutrition
- GI-Hepatology-Nutrition Section
- Washington DC Veterans Affairs Medical Center
The morbidity and mortality associated with being overweight or obese have been known to the medical profession since the time of Hippocrates more than 2500 years ago. Overweight refers to a weight above the "normal" range, with normal defined on the basis of actuarial data. This is determined by calculating the body mass index (BMI, defined as the weight in kilograms divided by height in meters squared). Overweight is defined as a BMI of 25 to 29.9 kg/m2; obesity is defined as a BMI of ≥30 kg/m2. Severe obesity is defined as a BMI ≥40 kg/m2 (or ≥35 kg/m2 in the presence of comorbidities). Although these categorical definitions are clinically useful, it is clear that the risks imparted by increasing body mass follow a continuum.
An overview of the management of obesity is provided here. Information on screening, evaluation, health hazards associated with obesity, and specific therapies are reviewed in detail elsewhere.
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- IMPORTANCE OF WEIGHT LOSS
- APPROACH TO THERAPY
- Goals of treatment
- Identify candidates
- Initial treatment
- - Comprehensive lifestyle intervention
- - Dietary therapy
- - Exercise
- - Behavior modification
- Subsequent treatment
- - Drug therapy
- - Surgery
- - Liposuction
- - Complementary and alternative therapies
- Dietary supplements
- Risks of treatment
- Maintenance of weight loss
- CLINICAL GUIDELINES
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS