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Abstract

Although health practitioners traditionally have not been trained in the medical management of obesity, they attain expertise in the treatment of its comorbidities—those conditions associated with, exacerbated by, or even caused by obesity, such as coronary artery disease, hypertension, type 2 diabetes, obstructive sleep apnea, degenerative joint disease, cancers (endometrium, colon, renal cell, breast, and prostate), gout, nonalcoholic steatohepatitis (NASH), polycystic ovary (PCO) syndrome, and other gynecologic conditions (Table 2-1).

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References

  1. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 2004;291:2847–2850.

    Article  CAS  PubMed  Google Scholar 

  2. Mokdad A, Marks J, Stroup D, Gerberding J. Actual causes of death in the Unites States, 2000. JAMA 2004;291:1238–1245.

    Article  PubMed  Google Scholar 

  3. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA 2003;289:187–193.

    Article  PubMed  Google Scholar 

  4. Dietz WH. Overweight in childhood and adolescence. N Engl J Med 2004;350:855–857.

    Article  CAS  PubMed  Google Scholar 

  5. Overweight, obesity, and health risk. National Task Force on the Prevention and Treatment of Obesity. Arch Intern Med 2000;160:898–904.

    Google Scholar 

  6. Lenfant C. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Bethesda: National Institutes of Health, 1998.

    Google Scholar 

  7. Savel RH, Gropper MA, Macura JM, Lazzaro RS. Management of the Critically Ill Obese Patient. www.uptodate. com, 2004.

    Google Scholar 

  8. Brolin RE. Gastric bypass. Surg Clin North Am 2001;81:1077–1095.

    Article  CAS  PubMed  Google Scholar 

  9. Yanovski SZ, Yanovski JA. Obesity. N Engl J Med 2002;346: 591–602.

    Article  CAS  PubMed  Google Scholar 

  10. Methods for voluntary weight loss and control. NIH Technology Assessment Conference Panel. Consensus Development Conference, 30 March to 1 April 1992. Ann Intern Med 1993;119:764–770.

    Google Scholar 

  11. Roldan EO. Childhood and Adolescent Obesity—Treatment of the Obese Patient. American Board of Bariatric Medicine Review Course, Scottsdale, Arizona, May 5, 2004.

    Google Scholar 

  12. Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004;109:433–438.

    Article  PubMed  Google Scholar 

  13. Blackburn G. Effect of degree of weight loss on health benefits. Obes Res 1995;3(suppl 2):211s–216s.

    Article  PubMed  Google Scholar 

  14. National Task Force on the Prevention and Treatment of Obesity NIH. Very low-calorie diets. JAMA 1993;270:967–974.

    Google Scholar 

  15. National Cholesterol Education Program. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation 1994;89:1333–1445.

    Google Scholar 

  16. Munoz KA, Krebs-Smith SM, Ballard-Barbash R, Cleveland LE. Food intakes of US children and adolescents compared with recommendations. Pediatrics 1997;100:323–329.

    Article  CAS  PubMed  Google Scholar 

  17. Food and Nutrition Intakes by Children 1994–1996, 1998. U.S. Department of Agriculture, Agricultural Research Service, 1999:Table Set 17.

    Google Scholar 

  18. Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res 2001;9:171–178.

    Article  CAS  PubMed  Google Scholar 

  19. Daniels SR. Abnormal weight gain and weight management: are carbohydrates the enemy? J Pediatr 2003;142: 225–227.

    Article  PubMed  Google Scholar 

  20. Brehm BJ, Seeley RJ, Daniels SR, D’Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardio-vascular risk factors in healthy women. J Clin Endocrinol Metab 2003;88:1617–1623.

    Article  CAS  PubMed  Google Scholar 

  21. Samaha FF, Iqbal N, Seshadri P, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med 2003;348:2074–2081.

    Article  CAS  PubMed  Google Scholar 

  22. Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 2003; 348:2082–2090.

    Article  CAS  PubMed  Google Scholar 

  23. Slentz CA, Duscha BD, Johnson JL, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE—a randomized controlled study. Arch Intern Med 2004;164:31–39.

    Article  PubMed  Google Scholar 

  24. Ross R, Dagnone D, Jones PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000;133:92–103.

    Article  CAS  PubMed  Google Scholar 

  25. Jakicic JM, Marcus BH, Gallagher KI, Napolitano M, Lang W. Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA 2003;290:1323–1330.

    Article  CAS  PubMed  Google Scholar 

  26. Gibbons RJ, Balady GJ, Bricker JT, et al. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). J Am Coll Cardiol 2002;40:1531–1540.

    Article  PubMed  Google Scholar 

  27. Wadden TA, Foster GD. Behavioral treatment of obesity. Med Clin North Am 2000;84:441–461, vii.

    Article  CAS  PubMed  Google Scholar 

  28. Methods for Voluntary Weight Loss and Control. Proceedings of NIH Technology Assessment Conference. Bethesda, Maryland, 30 March-1 April 1992. Ann Intern Med 1993; 119:641–770.

    Google Scholar 

  29. Fletcher AM. Thin for Life. Boston, Houghton Mifflin, 1994.

    Google Scholar 

  30. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr 1997;66:239–246.

    CAS  PubMed  Google Scholar 

  31. Shick SM, Wing RR, Klem ML, McGuire MT, Hill JO, Seagle H. Persons successful at long-term weight loss and maintenance continue to consume a low calorie, low fat diet. J Am Dietetic Assoc 1998;98:408–413.

    Article  CAS  Google Scholar 

  32. McGuire MT, Wing RR, Klem ML, Seagle HM, Hill JO. Long-term maintenance of weight loss: do people who lose weight through various weight loss methods use different behaviors to maintain their weight? Int J Obes 1998;22:572–577.

    Article  CAS  Google Scholar 

  33. Hendricks EJ. Pharmacotherapy—Treatment of the Obese Patient, 2004 American Board of Bariatric Medicine Review Course, Scottsdale, Arizona, 2004.

    Google Scholar 

  34. Obesity National Task Force on the Prevention and Treatment of Obesity. Long-term pharmacotherapy in the management of obesity. JAMA 1996;276:1907–1915.

    Google Scholar 

  35. Munro JF, MacCuish AC, Wilson EM, Duncan LJ. Comparison of continuous and intermittent anorectic therapy in obesity. Br Med J 1968;1:352.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Stallone DD. Long-term use of appetite suppressant medications: rationale and recommendations. Drug Dev Res 1992;26:1–20.

    Article  CAS  Google Scholar 

  37. Stafford RS, Radley DC. National trends in antiobesity medication use. Arch Intern Med 2003;163:1046–1050.

    Article  PubMed  Google Scholar 

  38. Jick H, Vasilakis C, Weinrauch LA, Meier CR, Jick SS, Derby LE. A population-based study of appetitesuppressant drugs and the risk of cardiac-valve regurgitation. N Engl J Med 1998;339:719–724.

    Article  CAS  PubMed  Google Scholar 

  39. Khan MA, Herzog CA, St Peter JV, et al. The prevalence of cardiac valvular insufficiency assessed by transthoracic echocardiography in obese patients treated with appetite-suppressant drugs. N Engl J Med 1998;339:713–718.

    Article  CAS  PubMed  Google Scholar 

  40. Weissman NJ, Tighe JF Jr, Gottdiener JS, Gwynne JT. An assessment of heart-valve abnormalities in obese patients taking dexfenfluramine, sustained-release dexfenfluramine, or placebo. Sustained-Release Dexfenfluramine Study Group. N Engl J Med 1998;339:725–732.

    Article  CAS  PubMed  Google Scholar 

  41. Kernan WN, Viscolli CM, Brass LM, et al. Phenylpropanolamine and the risk of hemorrhagic stroke. N Engl J Med 2000;343:1826.

    Article  CAS  PubMed  Google Scholar 

  42. Bray GA, Blackburn GL, Ferguson JM, et al. Sibutramine produces dose-related weight loss. Obes Res 1999;7:189–198.

    Article  CAS  PubMed  Google Scholar 

  43. Fujioka K, Seaton TB, Rowe E, et al. Weight loss with sibutramine improves glycaemic control and other metabolic parameters in obese patients with type 2 diabetes mellitus. Diabetes Obes Metab 2000;2:175–187.

    Article  CAS  PubMed  Google Scholar 

  44. Guerciolini R. Mode of action of orlistat. Int J Obes Relat Metab Disord 1997;21(suppl 3):S12–23.

    CAS  PubMed  Google Scholar 

  45. Heck AM, Yanovski JA, Calis KA. Orlistat, a new lipase inhibitor for the management of obesity. Pharmacotherapy 2000;20:270–279.

    Article  CAS  PubMed  Google Scholar 

  46. Tonstad S, Pometta D, Erkelens DW, et al. The effect of the gastrointestinal lipase inhibitor, orlistat, on serum lipids and lipoproteins in patients with primary hyperlipidaemia. Eur J Clin Pharmacol 1994;46:405–410.

    Article  CAS  PubMed  Google Scholar 

  47. Hukshorn CJ, Saris WH, Westerterp-Plantenga MS, Farid AR, Smith FJ, Campfield LA. Weekly subcutaneous pegylated recombinant native human leptin (PEG-OB) administration in obese men. J Clin Endocrinol Metab 2000;85: 4003–4009.

    Article  CAS  PubMed  Google Scholar 

  48. Flint A, Raben A, Astrup A, Holst JJ. Glucagon-like pep tide 1 promotes satiety and suppresses energy intake in humans. J Clin Invest 1998;101:515–520.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  49. Batterham RL, Cohen MA, Ellis SM, et al. Inhibition of food intake in obese subjects by peptide YY3-36. N Engl J Med 2003;349:941–948.

    Article  CAS  PubMed  Google Scholar 

  50. Ettinger MP, Littlejohn TW, Schwartz SL, et al. Recombinant variant of ciliary neurotrophic factor for weight loss in obese adults: a randomized, dose-ranging study. JAMA 2003;289:1826–1832.

    Article  CAS  PubMed  Google Scholar 

  51. Cota D, Marsicano G, Tschop M, et al. The endogenous cannabinoid system affects energy balance via central orexigenic drive and peripheral lipogenesis. J Clin Invest 2003; 112:423–431.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  52. Bent S, Tiedt TN, Odden MC, Shlipak MG. The relative safety of ephedra compared with other herbal products. Ann Intern Med 2003;138:468–471.

    Article  PubMed  Google Scholar 

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March, V., Pierce, K. (2007). The Medical Management of Obesity. In: Schauer, P.R., Schirmer, B.D., Brethauer, S.A. (eds) Minimally Invasive Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68062-0_2

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  • DOI: https://doi.org/10.1007/978-0-387-68062-0_2

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