Management of obesity

We live in an overweight society. Although food consumption has not increased dramatically over the last two decades, physical activity has markedly diminished. However, recent studies suggest that weights up to 20% above ideal body weight do not carry a significant risk of increased mortality in the absence of other chronic diseases. A team approach helps maintain patient motivation, the key to an effective weight-loss program. An efficient weight-loss and weight-maintenance program in the moderately obese patient includes modification of eating patterns, an individualized balanced fuel-source diet, and an exercise program to allow caloric deficit of approximately 500 calories a day. We must realize that for morbidly obese patients in whom the amount of caloric restriction necessary to reach and maintain a desirable body weight may be incompatible with a reasonable quality of life, surgery is warranted. The aggressiveness of our therapeutic regimen should always depend on the risk of morbidity and mortality associated with the patient's degree of obesity.