OBESITY AND ITS HEALTH RISKS

Obesity continues to increase in prevalence, now affecting more than o ne third of the adult population of the United States. The health risk s of obesity are proportional to increase in body mass index (weight i n kilograms divided by the square of the height in meters), and includ e adult-onset diabetes, hypertension, hyperlipidemia and coronary arte ry disease, respiratory failure, and increased cancer risk. The recogn ized gastrointestinal complications reviewed in this article include i ncreased risks of gallstones (especially during weight reduction); pan creatitis related to gallstones or hyperlipidemia with worse clinical outcome; nonalcoholic steatohepatitis; and increased risks of adenocar cinoma of the esophagus, colorectal adenoma, and cancer. New studies c ontinue to define abnormalities in the genetic regulation of appetite and energy metabolism in experimental animals and human obesity. Treat ment options continue to evolve, with improved pharmacologic approache s to appetite and strong support for gastric bypass surgery as the mos t effective treatment of severely obese patients.