OBESITY AS A CHRONIC DISEASE - MODERN MEDICAL AND LIFE-STYLE MANAGEMENT

The United States is in the midst of an epidemic of obesity involving more than one third of the adult population. The prevalence of obesity increased by 40% between 1980 and 1990. Obesity is a chronic disease with a multifactorial etiology including genetics, environment, metabo lism, lifestyle, and behavioral components. A chronic disease treatmen t model involving both lifestyle interventions and, when appropriate, additional medical therapies delivered by an interdisciplinary team in cluding physicians, dietitians, exercise specialists, and behavior the rapists offers the best chance for effective obesity treatment. Lifest yle factors such as proper nutrition, regular physical activity, and c hanges in eating behaviors should be coordinated by this team. This re view addresses the modern epidemic of obesity, the strong association between obesity and comorbidities such as coronary heart disease, type 2 diabetes, hypertension, and dyslipidemia. Ln addition to obesity, t he health risks of abdominal obesity and adult weight gain are discuss ed. The evidence that supports health benefits from modest weight loss (between 5% and 10% of body weight) is evaluated and the 5 key princi ples of effective obesity therapy are put forward. Obesity is a therap eutic challenge best met by teams of health care professionals, includ ing dietitians and physicians, working together to deliver optimal tre atment.