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Obesity and Therapeutic Approaches to Weight Loss

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Comprehensive Cardiovascular Medicine in the Primary Care Setting

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Weight gain and obesity are becoming the most significant chronic public health conditions of our generation, impacting the well-being, productivity, longevity, and economics of our society. Obesity, along with diet and physical inactivity, is estimated to be responsible for approximately 400,000 preventable deaths per year and is expected to soon rival cigarette smoking as the most important public health concern 1. More than one-third of US adults—over 72 million people—were obese in 2005–2006 2, accounting for over 9% of total annual US medical expenditures 3. The etiology of obesity is multifactorial, brought about by an interaction between predisposing genetic and metabolic factors and a rapidly changing environment, one that favors excessive caloric intake while at the same time reducing opportunities to engage in a physically active lifestyle.

Key Points

• The etiology of obesity is multifactorial, brought about by an interaction between predisposing genetic and metabolic factors and a rapidly changing environment.

• The USPSTF recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions.

• Assessment of the patient should include the evaluation of body mass index (BMI), waist circumference, and overall medical risk.

• Obesity is a risk factor for multiple cardiovascular diseases accounting for 13% of total CVD mortality.

• The primary goal of treatment is to improve obesity-related, co-morbid conditions and reduce the risk of developing future co-morbidities through lifestyle, pharmacologic, and surgical interventions, when indicated.

• The initial goal of weight loss therapy is to reduce body weight by approximately 10% from baseline.

• Lifestyle management incorporates the three essential components of obesity care: dietary therapy, physical activity, and behavior therapy.

• The combination of dietary modification and exercise is the most effective behavioral approach for treatment of obesity.

• Adjuvant pharmacological treatments should be considered for patients with a BMI ≥30 kg/m2 or with a BMI ≥27 kg/m2 who also have concomitant obesity-related risk factors.

• Bariatric surgery can be considered for patients with severe obesity (BMI >40 kg/m2) or those with moderate obesity (BMI >35 kg/m2) associated with a serious medical condition.

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Authors and Affiliations

  1. Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Robert F. Kushner MD

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  1. Robert F. Kushner MD
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Editors and Affiliations

  1. Sterling Rock Falls Clinic, 101 E. Miller Road, Sterling, 61081, USA

    Peter P. Toth

  2. Brigham & Women's Hospital, Cardiovascular Division, Harvard Medical School, Longwood Ave. 350, Boston, 02115, USA

    Christopher P. Cannon

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Kushner, R.F. (2011). Obesity and Therapeutic Approaches to Weight Loss. In: Toth, P., Cannon, C. (eds) Comprehensive Cardiovascular Medicine in the Primary Care Setting. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-963-5_4

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  • DOI: https://doi.org/10.1007/978-1-60327-963-5_4

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