Weight control and nutrition: knowing when to intervene

The average weight of American adults is increasing, despite vast sums being spent on attempts at weight loss. Above-average weight in midlife is associated with increased morbidity and mortality as patients age. Nonetheless, there is confusion about what are "desirable" weight levels. Commonly-used actuarial tables do not account for the modest, normal weight gains seen at midlife; therefore, age-adjusted tables are recommended. Treatment of obesity, one of the most common malnutrition disorders, is difficult, requires a "chronic disease" approach, and should be considered in the context of other risks to health.