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Preface

It is with great pleasure that we present our new book Obesity: Prevention and Treatment. This is a book for every health-care provider who wishes to understand both the basic science and the clinical applications behind the prevention and treatment of obesity and its associated conditions. Never has there been a time when these issues are more critical to address.

The prevalence of overweight and obesity in the United States and the rest of the industrialized world has skyrocketed in the past 20 years. Currently, over two-thirds of the adult population in the United States is either overweight or obese. Shockingly, the prevalence of obesity has grown 40% in the last decade, for which we have reliable data.

Obesity is associated with numerous significant medical conditions as follows:

Obesity is strongly associated with diabetes (80%-85% of diabetic patients in the United States are obese).

• Obesity is strongly associated with hypertension (40%-70% of hypertension patients in the United States are obese).
• Obesity is strongly associated with dyslipidemia (40%-50% of dyslipidemia patients in the United States are obese).
• Obesity is strongly associated with the metabolic syndrome (the current prevalence of the metabolic syndrome in the adult population of the United States is estimated to be between 25% and 35%).
• Obesity is strongly associated with glucose intolerance (recent CDC estimates suggest that 35%-40% of the adult population in the United States has glucose intolerance).
• Obesity is the leading cause of osteoarthritis in women and the second leading cause of osteoarthritis in men.
• Obesity is one of the leading causes of cancer (second only to smoking), and the gap is closing rapidly.

In addition to these grim statistics on the prevalence of obesity among adults, an equally significant epidemic is the occurrence of obesity in children, which has tripled in the last 30 years in the United States. Associated with this increase are significant increases in diabetes, hypertension, lipid problems, and the metabolic syndrome in children

This problem is neither unique to the United States nor to other developed countries. Less developed nations are also experiencing rapid growth in the prevalence of obesity, making this a worldwide epidemic. The World Health Organization estimates that there are now 1.5 billion people in the world who are obese.

Obesity is also causing enormous health-care expenditures in the United States and other countries. A government-sponsored report issued on July 28, 2009, estimates that obesity accounts for 9.1% of all health-care expenditures in the United States.

Over $140 billion are currently being spent in the United States annually to treat obesity and obesity-related conditions. There can be no effective health-care reform unless the growing problem of obesity is resolved.

There is some good news in this otherwise grim picture. The Institute of Medicine has estimated that significant reduction in risk factors for various metabolic diseases occurs in overweight or obese individuals who lose as little as 5% of their body weight. The Diabetes Prevention Program Study showed that individuals with glucose intolerance who lost 5%-7% of their body weight by adopting some simple nutritional practices and increasing their physical activity reduce their risk of developing diabetes by 58%. The National Weight Control Registry (a registry of over 3000 individuals who have lost at least 30 lb and kept it off for at least one year) provides important data about how individuals can lose weight and keep it off.

To meet the challenge of providing a book that spans modern knowledge about obesity from its basic pathophysiology to its clinical treatment, we have been joined by an internationally distinguished group of scientists and clinicians. We have challenged all of our collaborating authors to blend state-of-the-art knowledge in basic science with a particular emphasis on clinical applications that will be relevant to the practicing physician and other health-care workers, and all of the authors have responded to this challenge admirably.

What has emerged is a state-of-the-art compendium of information about the modern understandings of obesity-both its prevention and treatment. We hope that this book will help guide physicians, nurses, nutritionists, exercise physiologists, and other health-care providers as well as students in these disciplines as they take steps to both prevent obesity and/or, if already present, treat it and its associated conditions.

The worldwide epidemic of obesity demands the best practices, information, and commitment on the part of health-care workers. We are proud to play a role in helping to combat this major worldwide epidemic with Obesity: Prevention and Treatment.