Clinical obesity in adults and children

Cover
Title Page
Copyright Page
Contents
List of Contributors
Preface
Dedication
List of Abbreviations
Part 1 Obesity
	Chapter 1 Obesity – Introduction: History and the Scale of the Problem Worldwide
		Obesity as a public health problem
		Lower limits of BMIs in non-Caucasians?
		Morbidity burden starts at much lower BMIs
		Obesity epidemic starts in the early 1980s
		The global epidemic gets underway
		Abdominal obesity
		Different regional societal burdens of obesity with abdominal obesity
		Historical analyses of contributors to obesity
		The burden of obesity
		The economic impact of excess weight gain
		Conclusions
		References
	Chapter 2 The Epidemiology and Social Determinants of Obesity
		Introduction
		Defining excess body fat
		Adult obesity
		Childhood obesity
		Global obesity
		Social determinants of obesity
		Conclusions
		References
Part 2 Causes of Obesity
	Chapter 3 Fetal and Infant Origins of Obesity
		Background
		Assessing obesity in children
		Conceptual frameworks
		Study designs
		Developmental risk factors
		Biology and mechanisms
		Estimating population attributable risks
		Implications for policy and practice
		Acknowledgments
		References
	Chapter 4 Genes and Obesity
		Introduction
		Historical perspective
		Gene–environment interactions
		Evidence for the heritability of fat mass
		Adoption studies
		Twin studies
		Pleiotropic obesity syndromes
		Prader–Willi syndrome
		Albright hereditary osteodystrophy
		Bardet–Biedl syndrome
		Molecular mechanisms involved in energy homeostasis
		Rodent models of obesity
		Leptin–melanocortin pathway
		Monogenic obesity syndromes affecting the leptin-melanocortin pathway
		Response to leptin therapy
		Leptin receptor deficiency
		POMC deficiency
		Prohormone convertase 1 deficiency
		MC4R deficiency
		Conclusions
		References
	Chapter 5 Bias, Stigma, and Social Consequences of Obesity
		Social consequences for adults
		Social consequences for youth
		Impact of weight stigma on health
		Interventions to prevent and reduce weight stigma
		Conclusion
		References
	Chapter 6 Ecology, Protein Leverage, and Public Health
		Introduction
		An ecological view of nutrition
		Human macronutrient regulation
		Human nutritional ecology
		Bringing it all together: complex systems
		Conclusions
		References
	Chapter 7 The Living Environment and Physical Activity
		From the environment to behaviors to obesity
		Physical activity and health
		Physical activity and weight gain
		Spatial variation in obesity
		Measuring attributes of the built environment
		Relations between the built environment, physical activity, and obesity
		Research trends
		Changes in the urban environment
		Conclusion
		References
	Chapter 8 Psychobiology of Obesity: Eating Behavior and Appetite Control
		Setting the scene
		Can obesity be managed through behavior change?
		Complex bio-cultural system of appetite control
		The bio-behavioral appetite system: tonic and episodic processes
		The satiety cascade: homeostatic and hedonic processes
		Individual variation in susceptibility to overconsumption: phenotypes for appetite control
		Satiety responsiveness and the low satiety phenotype
		Sensitivity to food reward
		Compensation in response to exercise
		Implications for the treatment and prevention of obesity and future directions
		Closing comments
		References
	Chapter 9 Energy Balance and Body Weight Homeostasis
		Introduction
		Basic concepts and principles in human energetics
		Control of food intake
		Autoregulatory adjustments in energy expenditure
		Integrating intake and expenditure
		References
Part 3 Obesity as a Disease
	Chapter 10 Obesity, Ectopic Fat and Type 2 Diabetes
		Introduction
		Epidemiology
		Not all fat is the same
		Metabolically healthy obese and metabolically unhealthy lean
		Pathogenesis of visceral and ectopic fat accumulation
		Factors affecting body fat distribution
		Linking ectopic fat accumulation to diabetes
		How can we measure VAT and ectopic fat
		Therapy
		Conclusion
		References
	Chapter 11 Obesity and Dyslipidemia, Importance of Body Fat Distribution
		Introduction
		Limitations to fat storage
		Hyperlipidemia in relation to adiposity
		The dynamics and difference of adipose tissue depot functions in the body in relation to hyperlipidemia
		Associations between plasma lipids and lipoproteins and discrete fat depots
		References
	Chapter 12 Obesity and Fertility
		Introduction
		References
	Chapter 13 Metabolic Syndrome and Metabolic Dysfunction-Associated Fatty Liver Disease
		Introduction
		Pathogenesis of MS
		Pathogenesis and clinical implications of MAFLD
		Association between MS and MAFLD
		Pathological link between MAFLD and MS
		Inflammation, linked with MS, is the main determinant in progression from NAFLD to NASH
		Increased inflow of FFAs and de novo hepatic lipogenesis are the main determinants of MAFLD
		Oxidative and ER stresses are involved in the association between MS and MAFLD
		Adiponectin, a critical link between MS and MAFLD
		Role of gut microbiota in the crosstalk between MAFLD and MS
		Association of sarcopenia with MS and MAFLD
		Medications for the treatment of MAFLD/NASH
		Role of SGLT2 inhibitors
		Role of GLP1 receptor agonists
		Conclusions
		References
	Chapter 14 Cardiovascular Consequences
		Introduction
		Epidemiology
		Risk associations in people with the prevalent disease – obesity paradox or confounding?
		Genetics of obesity and cardiovascular outcomes
		Mechanisms
		Interventions: weight loss benefits in CV medicine
		Timing of weight loss benefits on metabolic versus ASCVD outcomes
		Summary
		References
	Chapter 15 Obstructive Sleep Apnea
		Sleep-disordered breathing
		Sleep-disordered breathing: epidemiology
		Sleep-disordered breathing: clinical aspects
		Sleep disordered breathing: treatment
		Conclusion
		References
	Chapter 16 Obesity and Cancer
		General mechanisms linking obesity and cancer
		Colorectal cancer
		Breast cancer
		Stomach cancer
		Liver cancer
		Esophageal cancer
		Ovarian cancer
		Intentional weight loss
		Early life risk factors for cancer
		Dietary characteristics
		Comprehensive integration of the evidence-base
		Disclosure
		References
Part 4 Management of Adult Obesity
	Chapter 17 A Practical Approach to Contemporary Obesity Management
		Introduction
		Obesity
		Weight loss
		Weight control in the age of SARs-CoV-2 coronavirus (COVID-19)
		Aims of obesity treatment
		Current obesity treatment options
		Where should these interventions be available/delivered?
		Summary
		Appendix A Overview of obesity care
		Physical examination and investigations
		Judging the success of weight control/obesity treatment programs
		References
	Chapter 18 Dietary Management of Obesity: Eating Plans
		Dietary treatment of obesity
		Energy deficit
		Energy density
		Low-fat diets
		Plant-based diets
		Mediterranean diets
		Low energy diets
		Partial meal replacement therapy
		Low carbohydrate or higher protein diets
		Ketogenic diets
		Very low energy (calorie) diets (VLEDs)
		Intermittent energy restriction
		The less restrictive dieting approach
		Ultra-processed food
		Sugar sweetened beverages
		Basic principles
		Nutrition in practice
		Portion sizes and eating frequency
		Maintenance and/or success
		Clinical guidelines
		Conclusion
		References
	Chapter 19 The Behavioral Treatment of Obesity
		Behavioral treatment
		Components of behavioral treatment
		Dietary options for weight loss
		Physical activity
		Structure of behavioral treatment
		Short-and long-term weight losses
		Strategies to improve long-term weight losses
		New behavioral approaches
		Implementation and dissemination of behavioral treatment
		Conclusion
		References
	Chapter 20 Role of Exercise and Physical Activity in Promoting Weight Loss and Weight Loss Maintenance
		Introduction
		Operational definitions
		Relationships between PA levels and body mass
		Relationships between sedentary behavior and body mass
		Energy balance considerations
		Exercise and weight reduction
		Resistance training
		Exercise factors that may influence magnitude of weight loss
		Can walking interventions aid weight loss?
		Using other measures of excess weight to determine the metabolic benefit of exercise
		Biological response to weight loss from any type of intervention
		Evidence for metabolic adaptations to exercise
		Heterogeneity in exercise response and the concept of responders vs. nonresponders
		Use of exercise/PA as a tool to achieve weight loss maintenance (WLM)
		Conclusions
		References
	Chapter 21 Adjunctive Therapy, Including Pharmacotherapy
		Introduction and general principles
		Classification of obesity medication
		Currently approved drugs
		Potential future targets including medications not licensed for use in obesity
		The use of anti-obesity drug therapy post-bariatric surgery
		Conclusion
		References
	Chapter 22 The Management of Obesity: Surgery
		Introduction
		The evolution of surgical technique
		Overview of outcomes from bariatric procedures
		Weight loss outcomes from bariatric surgery
		Changes in health after bariatric surgery
		Survival after bariatric surgery
		The Swedish Obese Subjects (SOS) study
		Safety of bariatric surgery
		Conclusion
		References
	Chapter 23 Weight Loss Maintenance and Weight Cycling
		What is weight loss maintenance and how is it defined?
		What lifestyle characteristics are associated with weight maintenance success?
		Interventions – what works for weight loss maintenance, and when
		Relationship between quantity of intentional weight loss and weight maintenance success
		Weight maintenance in those postbariatric surgery
		Weight loss maintenance post pharmacologically assisted weight loss
		Weight maintenance using Intermittent weight loss LELD approaches
		Clinical and commercial approaches for weight loss maintenance
		Conclusion
		References
	Chapter 24 Training and Medical Systems for Obesity Care
		The current state of obesity knowledge and care
		Medical education
		Provider training and competencies
		Obesity medicine education collaborative competencies
		Medical licensure
		Obesity medicine as a specialty
		Systems of care for obesity
		Summary
		References
Part 5 Childhood Obesity
	Chapter 25 The Prevention of Childhood Obesity
		Introduction
		Obesity prevention in clinical settings
		Early childhood
		Schools
		Behavior change interventions in communities
		Policy interventions in communities
		Country-level Initiatives
		Sugary drink taxes
		Novel approaches to obesity prevention
		Criteria for the selection of prevention strategies
		Summary
		References
	Chapter 26 Consequences of Childhood and Adolescent Obesity: The Need for a Broad Approach
		Seeing the child and youth in context
		Comparing the consequences of obesity, and obesity as a causal factor of chronic health conditions
		Conclusion
		References
	Chapter 27 The Treatment of Childhood and Adolescent Obesity
		Introduction
		Approach to the child with obesity
		Treatment overview
		Treating obesity as a chronic disease
		Behavioral interventions
		Motivational interviewing and primary care counseling to modify lifestyle behaviors
		Comprehensive multidisciplinary obesity treatment
		Specific dietary modifications
		Pharmacotherapy
		Information systems
		Conclusions
		References
Part 6 Policy Approaches
	Chapter 28 Policy Approaches to Obesity Prevention
		Early interest in obesity policy: the 1970s and 1980s
		Ecological determinants of obesity: the 1990s and early 2000s
		Global development and systems approach: the early 2000s
		Targets and “best buys” in the early 2010s
		From best buys to regulating commerce: the later 2010s
		A sustainable political economy of health: the 2020s
		The political economy of obesity: building a sustainable response
		Conclusion
		Notes
		References
	Chapter 29 The Double Burden of Malnutrition
		Introduction
		Scope of the problem and prevalence
		Dynamics of the double burden
		Early childhood development amidst double burden malnutrition
		Conclusion
		Acknowledgments
		References
	Chapter 30 Taxes, Subsidies, and Policies
		Introduction
		Food environments and dietary determinants
		Impact on dietary patterns and health
		Breastfeeding practices
		Interventions in healthcare settings
		Marketing restrictions for unhealthy products
		References
	Chapter 31 The Global Syndemic of Obesity, Undernutrition, and Climate Change
		Background
		Malnutrition in all its forms
		The Global Syndemic
		Policy inertia
		Systems thinking approach to the Global Syndemic
		Double- and triple-duty actions
		Applying systems approaches – cities
		Applying systems approaches – communities
		References
Index
EULA