1st Edition
A Guide to Obesity and the Metabolic Syndrome Origins and Treatment
In the historical record there is abundant evidence that obesity was a medical and health concern as long as medicine has been practiced. The idea of diet and exercise are bulwarks in the fight against obesity in history from the time of Hippocrates to the 16th century—a span of 2,000 years. However, our scientific understanding of this problem is only a little over 200 years old. An examination of the root cause of what many consider the obesity epidemic, A Guide to Obesity and the Metabolic Syndrome traces the origins and types of obesity and its treatment.
Examining in detail the developing treatment for obesity, this book provides:
- A history of obesity, including treatment, proposed causes, and perceptions
- An examination of the causes and problems associated with obesity
- A discussion of lifestyle, diet, exercise, and treatment strategies
- A detailed look at the medications and surgeries available for obesity
The fact that we have an epidemic of obesity today that is covering the globe suggests that the strategically simple ideas of eating less and exercising more, ideas that require commitment and personal involvement by the individual, have not been very successful. As we move forward in trying to understand this problem, we need to be alert to strategies and tactics that may not require individual motivation and commitment—history has shown that they do not work well. This book supplies guidance on developing and designing novel strategic interventions against obesity and metabolic disorders.
Origins
Origins of Obesity in the Scientific Era—AD 1500 to the Present
Introduction
Sixteenth Century
Seventeenth Century
Eighteenth Century
Nineteenth Century
Twentieth Century: An Age of Specialization in Science and Medicine
Definition, Measurement, and Prevalence
Introduction
Definitions
Describing Body Composition
Methods of Measuring Body Weight and Body Fat
Instruments Used to Measure Body Composition
Instrumental Methods for Measuring Visceral Fat
Body Fat through the Life Span
Body Fat and Body Energy Stores
Criteria for the Metabolic Syndrome
Prevalence of Obesity
Metabolic Syndrome
Conclusion
Genetic, Metabolic, and Social Origins of Obesity
Introduction
Genetic Factors
Epigenetic and Intrauterine Imprinting
Environmental Agents and Obesity: An Epidemiologic Approach
Regulation of Body Fat: A Homeostatic Model of Energy Regulation
Effects of Obesity on Health and Metabolism
Introduction
Historical Context for the Risks of Overweight as a Disease
Costs of Obesity
The Pathology of Obesity
The Pathophysiology of Central and Total Fat
Benefits and Potential Risks of Weight Loss
Treatment
Prevention, Evaluation, and Introduction to Treatment
Introduction
Prevention of Obesity
Introduction to Treatment
Criteria for Evaluating Outcomes
Lifestyle, Diet, and Exercise: Cognitive Solutions
Introduction to Cognitive Solutions for Weight Loss
Lifestyle Change: A Cognitive Solution
Diet: A Cognitive Solution
Physical Activity: A Cognitive Solution
Cognitive Strategies to Maintain Weight Loss
Medications for Obesity
Brief History of the Drug Treatment for Obesity
Mechanisms that Modulate Food Intake and Energy Expenditure: The Basis for Pharmacological Interventions
Drugs Approved by the Food and Drug Administration for the Treatment of Obesity
Drugs Approved for Other Uses that Have Effects on Body Weight
Combinations of Drugs Used for Weight Loss
Drugs in Late Stages of Clinical Evaluation
Concepts for Antiobesity Drugs in Earlier Stages of Development
Complementary and Herbal Medicine
Surgery for Obesity
Introduction
Rationale for Surgical Intervention for Obesity
Indications
Contraindications
Bariatric Surgery for Pediatric Patients
Effectiveness of Surgical Procedures
Mechanisms for Weight Loss
Benefits from Bariatric Surgery
Complications
Other Procedures
Postscript—Obesity in the Twenty-First Century
Lessons We Have Learned in this Book
Where Do We Go in the Twenty-First Century?
Biography
George A. Bray, M.D., MACP, MACE is a Boyd Professor at the Pennington Biomedical Research Center of Louisiana State University in Baton Rouge, Louisiana, and Professor of Medicine at the Louisiana State University Medical Center in New Orleans. He was the first Executive Director of the Pennington Biomedical Research Center in Baton Rouge, a post he held from 1989 to 1999. He is a Master in both the American College of Physicians and the American College of Endocrinology. Dr. Bray founded the North American Association for the Study of Obesity (NAASO now The Obesity Society), and he was the founding editor of its journal, Obesity Research, as well as co-founder of the International Journal of Obesity and the first editor of Endocrine Practice, the official journal of the American College of Endocrinologists.
Dr. Bray has received many awards during his medical career. They have included the Johns Hopkins Society of Scholars, Honorary Fellow, American Dietetic Association, Joseph Goldberger Award from the American Medical Association, the McCollum Award from the American Society of Clinical Nutrition and the Osborne-Mendel Award from the American Society of Nutritional. Dr. Bray has also received the TOPS Award from NAASO, the Weight Watchers Award, the Bristol-Myers Squibb Mead Johnson Award in Nutrition and the Stunkard Lifetime Achievement Award. During the past 40 years, Dr. Bray has authored or coauthored more than 1,700 publications, ranging from peer-reviewed articles to reviews, books, book chapters and abstracts.
