[Obesity. Its medico-surgical treatment]

Obesity has been defined as excessive deposition of body fat tissue that risks the health and survival of the patient. It affects almost 30 per cent of whole population in western societies and it's also becoming a common problem in developing countries as rural areas are slowly decreasing in face of urban growing. In Mexico obesity affects as much as 28 per cent of the population of selected urban areas and the trend seems to follow the incidence in North America. There are genetic, environmental, physiological, psychological, social and cultural factors that determine or influence the presence of obesity in modern societies. To date the most accepted approach to the management of this problem lays on 3 main aspects: diet, exercise and behaviour modification. Pharmacological therapy should be limited to selected cases in which associated clinical risks warrant more urgent intervention. Surgical therapy is indicated for morbid obesity in which there is greater than 70 per cent excess weight. Prevention of obesity should remain one of the top priorities in public health and should take genetic, physiological, environmental, social, psychological, cultural and economic factors into consideration.