Handbook of Obesity: Clinical Applications PDF

Preface

Welcome to the third edition of the Handbook of Obesity: Evaluation and Treatment. When the second edition of this book was published, it was printed in two separate volumes. Volume I dealt with etiology and pathophysiology, and Volume II with clinical applications. This division made it easier to focus on one aspect of obesity at a time when revising this complex body of work. The growth of activity in the therapeutic arena made the second volume, Clinical Applications, the obvious one to tackle first for the third edition.

The new edition of the second volume has been divided into five parts. The first part deals with evaluation of the overweight or obese patient. Included in this section are chapters on evaluation of individual patients, a critical evaluation of the waist circumference in evaluating central adiposity, and genetic strategies in evaluating overweight and obese people. In addition, there are chapters on the usefulness of waist circumference and how to handle it in the health care setting. The other five chapters in Part I deal with cultural differences associated with the approach to obesity, the effects of bias and discrimination, with the issues around weight loss and regain as an example of the false hope syndrome, with the impact of voluntary weight loss on reducing the risk of morbidity and mortality, and finally with approaching the overweight patient in the primary care setting.

Part II focuses on prevention of obesity. This is the obvious first line of defense in our effort to curtail the obesity pandemic. We have included five chapters in this part. There is a chapter on preventing obesity in children and one on preventing obesity in adults, followed by chapters that deal with ways to modify the obesogenic environment, strategies for reengineering the built environment, and the relationship of the food industry to obesity.

The largest number of chapters in this volume is in Part III, which is devoted to the medical management of obesity. It covers behavior, diet, exercise, and pharmacology. Part III begins with a chapter on behavioral approaches to obesity, followed by one on the behavioral techniques that can be used to prevent regain of weight once it is lost. This is followed by a chapter on diets and their use and one on the role of exercise in treatment and prevention of obesity. The next group of chapters is on pharmacological approaches. Sibutramine and orlistat, the only two drugs approved by the U.S. Food and Drug Administration, each have separate chapters. Next is a chapter on the cannabinoid CB1 receptor antagonists, one of which has been approved in Europe but not in the United States. Pramlintide is the subject of a separate chapter, followed by chapters on neuropeptide Y, melanocortin-4 receptor agonists, serotonin receptors, and the potential for histamine H3 receptors in the treatment of obesity. Part III ends with three chapters that cover herbal preparations, the potential for gene therapy, and approaches to patients with the metabolic syndrome.

Surgical treatment of obesity was presented in a single chapter in the second edition, but growth of the field has been such that the topic is now addressed in a separate Part IV with five chapters. These chapters cover operative procedures, the Swedish Obese Subjects (SOS) study as a long-term follow-up for operated patients, the laparoscopic procedures for this surgery, newer surgical strategies, and liposuction.

Part V covers a number of special issues. These include binge eating, the challenges from obesity in pediatric patients, issues in treating overweight patients in the clinic, the economic aspects of obesity, and the role of the government in dealing with this problem. We are indebted to a number of people for this volume. In particular, Ms. Nina Laidlaw, who assisted us through all the phases of the development of this third edition, deserves special recognition. She managed all aspects of our relations with the authors with patience and elegance. She reviewed all manuscripts in detail to ensure compliance with all requirements of the Publisher and made sure that all permissions had been obtained for the reproduction of material from other publications.

We are also grateful for the high-quality support given to us by Ms. Carole Lachney at the Pennington Biomedical Research Center. At Informa Healthcare, Inc., Ms. Sherri Niziolek has taken the principal role during the development of the manuscript. We are both indebted to each of them. But in the end, without the excellent writing from each of the authors and their collaborators, we would not have the superb chapters that make up this volume. We thank all of them.