This report issues a call for urgent action to combat the growing
epidemic of obesity, which now affects developing and
industrialized countries alike. Adopting a public health approach,
the report responds to both the enormity of health problems
associated with obesity and the notorious difficulty of treating
this complex, multifactorial disease. With these problems in mind,
the report aims to help policy-makers introduce strategies for
prevention and management that have the greatest chance of success.
The importance of prevention as the most sensible strategy in
developing countries, where obesity coexists with undernutrition,
is repeatedly emphasized.Recommended lines of action, which reflect
the consensus reached by 25 leading authorities, are based on a
critical review of current scientific knowledge about the causes of
obesity in both individuals and populations. While all causes are
considered, major attention is given to behavioural and societal
changes that have increased the energy density of diets,
overwhelmed sophisticated regulatory systems that control appetite
and maintain energy balance, and reduced physical activity.
Specific topics discussed range from the importance of fat content
in the food supply as a cause of population-wide obesity, through
misconceptions about obesity held by both the medical profession
and the public, to strategies for dealing with the alarming
prevalence of obesity in children.The report has eleven chapters
presented in five parts. Part one, which assesses the magnitude of
the problem, explains the system for classifying overweight and
obesity based on the body mass index, considers the importance of
fat distribution, and provides an overview of trends in all regions
of the world, concluding that obesity is increasing worldwide at an
alarming rate. Chapters in part two evaluate the true costs of
obesity in terms of physical and mental ill health, and the human
and financial resources diverted to deal with these problems.
Specific health consequences discussed include increased risk of
cardiovascular disease, cancer, and other noncommunicable diseases,
endocrine and metabolic disturbances, debilitating health problems,
and psychological problems. The health benefits and risks of weight
loss are also assessed.Part three draws on the latest research
findings to consider specific factors involved in the development
of overweight and obesity. Discussion centres on factors, such as
high intakes of fat, that may disrupt normal physiological
regulation of appetite and energy balance, and the role of dietary
factors and levels of physical activity. In terms of opportunities
for prevention, particular attention is given to the multitude of
environmental and societal forces that adversely affect food intake
and physical activity and may thus overwhelm the physiological
regulatory systems that keep weight stable in the long term. The
possible role of genetic and biological susceptibility is also
briefly considered.Against this background, the fourth and most
extensive part maps out strategies for prevention and management at
both the population and individual levels. Separate chapters
address the need to develop population-based strategies that tackle
the environmental and societal factors implicated in the
development of obesity, and compare the effectiveness of current
options for managing overweight or obese individuals. Specific
strategies discussed include dietary management, physical activity
and exercise programmes, behaviour modification, drug treatment,
and gastric surgery. While noting striking recent progress in the
development of drug treatments, the report concludes that gastric
surgery continues to show the best long-term success in treating
the severely obese. The final part sets out key conclusions and
recommendations for responding to the global obesity epidemic and
identifies priority areas where more research is urgently
needed...". the volume is clearly written, and carries a wealth of
summary information that is likely to be invaluable for anyone
interested in the public health aspects of obesity and fatness, be
they students, practitioner or researcher." - Journal of Biosocial
Science
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