Management of obesity
Affiliations & Notes
aPennington Biomedical Research Center/LSU, Baton Rouge, LA, USA
bDepartment of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, CIBEROBN, IdiSNA, Spain
cDepartment of Medicine (Obesity) University of Liverpool, Liverpool, UK
Article Info
Publication History:
Published February 8, 2016
DOI: 10.1016/S0140-6736(16)00271-3 External LinkAlso available on ScienceDirect External Link
Copyright: © 2016 Elsevier Ltd. All rights reserved.
Linked Articles
- Weighing up dietary patterns – Authors' replyThe LancetAugust 20, 2016
- Weighing up dietary patternsThe LancetAugust 20, 2016
- Weighing up dietary patternsThe LancetAugust 20, 2016
Download started
OkReferences
1.
WHO
WHO obesity and overweight fact sheet no 311
http://who.ubt.neduacebter.factsheet.fs311/en
Date: March 2013
(accessed Jan 7, 2015).
3.
Health and Social Care Information Centre
Statistics on obesity, physical activity and diet: England 2015
(accessed April 15, 2015).
4.
WHO regional office for Europe
Data and statistics
(accessed Jan 7, 2015).
5.
Ng, M ∙ Fleming, T ∙ Robinson, M ∙ et al.
Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013
Lancet. 2014; 384:766-781
6.
Scully, T
Public health: society at large
Nature. 2014; 508:S50-S51
7.
Gallagher, D ∙ Heymsfield, SB ∙ Heo, M ∙ et al.
Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index
Am J Clin Nutr. 2000; 72:694-701
8.
Romero-Corral, A ∙ Lopez-Jimenez, F ∙ Sierra-Johnson, J ∙ et al.
Differentiating between body fat and lean mass-how should we measure obesity?
Nat Clin Pract Endocrinol Metab. 2008; 4:322-323
9.
Ashwell, M ∙ Gunn, P ∙ Gibson, S
Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis
Obes Rev. 2012; 13:275-286
10.
Cerhan, JR ∙ Moore, SC ∙ Jacobs, EJ ∙ et al.
A pooled analysis of waist circumference and mortality in 650,000 adults
Mayo Clin Proc. 2014; 89:335-345
11.
Staiano, AE ∙ Bouchard, C ∙ Katzmarzyk, PT
BMI-specific waist circumference thresholds to discriminate elevated cardiometabolic risk in white and African American adults
Obes Facts. 2013; 6:317-324
12.
Tsai, AG ∙ Williamson, DF ∙ Glick, HA
Direct medical cost of overweight and obesity in the USA: a quantitative systematic review
Obes Rev. 2011; 12:50-61
13.
Finkelstein, EA ∙ Graham, WC ∙ Malhotra, R
Lifetime direct medical costs of childhood obesity
Pediatrics. 2014; 133:854-862
14.
Bray, GA
Diabetes and obesity—time bombs to be defused
Diabetes Care. 2015; 38:1997-1999
15.
Cawley, J ∙ Meyerhoefer, C
The medical care costs of obesity: an instrumental variables approach
J Health Econ. 2012; 31:219-230
16.
Wang, YC ∙ McPherson, K ∙ Marsh, T ∙ et al.
Health and economic burden of the projected obesity trends in the USA and the UK
Lancet. 2011; 378:815-825
17.
Finkelstein, EA ∙ Khavjou, OA ∙ Thompson, H ∙ et al.
Obesity and severe obesity forecasts through 2030
Am J Prev Med. 2012; 42:563-570
18.
Loeppke, R ∙ Taitel, M ∙ Haufle, V ∙ et al.
Health and productivity as a business strategy: a multiemployer study
J Occup Environ Med. 2009; 51:411-428
19.
Keith, SW ∙ Redden, DT ∙ Katzmarzyk, PT ∙ et al.
Putative contributors to the secular increase in obesity: exploring the roads less traveled
Int J Obes (Lond). 2006; 30:1585-1594
20.
Janesick, AS ∙ Shioda, T ∙ Blumberg, B
Transgenerational inheritance of prenatal obesogen exposure
Mol Cell Endocrinol. 2014; 398:31-35
21.
Whitlock, G ∙ Lewington, S ∙ Sherliker, P ∙ et al., the Prospective Studies Collaboration
Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies
Lancet. 2009; 373:1083-1096
22.
Li, C ∙ Ford, ES ∙ Zhao, G ∙ et al.
Prevalence of self-reported clinically diagnosed sleep apnea according to obesity status in men and women: National Health and Nutrition Examination Survey, 2005–2006
Prev Med. 2010; 51:18-23
23.
Berrington de Gonzalez, A ∙ Hartge, P ∙ Cerhan, JR ∙ et al.
Body-mass index and mortality among 1.46 million white adults
N Engl J Med. 2010; 363:2211-2219
24.
Leibel, RL ∙ Rosenbaum, M ∙ Hirsch, J
Changes in energy expenditure resulting from altered body weight
N Engl J Med. 1995; 332:621-628
25.
Greenway, FL
Physiological adaptations to weight loss and factors favouring weight regain
Int J Obes (Lond). 2015; 39:1188-1196
26.
Sturm, R ∙ An, R
Obesity and economic environments
CA Cancer J Clin. 2014; 64:337-350
27.
Bray GA. Prevention of obesity. In: De Groot LJ, Beck-Peccoz P, Chrousos G, et al, eds. Endotext. South Dartmouth: MDText.com, 2000–12: 1–28.28.
Wang, Y ∙ Wu, Y ∙ Wilson, RF ∙ et al.
Childhood obesity prevention programs: comparative effectiveness review and meta-analysis. Comparative effectiveness review no 115.Agency for Healthcare Research and Quality, Rockville, 2013
29.
Ryan, D ∙ Heaner, M
Guidelines (2013) for managing overweight and obesity in adults. Preface to the full report
Obesity (Silver Spring). 2014; 22(suppl 2):S1-S3
30.
Garvey, WT ∙ Garber, AJ ∙ Mechanick, JI
AACE Advanced framework for a new diagnosis of obesity as a chronic disease
(accessed Jan 15, 2015).
31.
Apovian, CM ∙ Aronne, LJ ∙ Bessesen, DH ∙ et al., the Endocrine Society
Pharmacological management of obesity: an endocrine Society clinical practice guideline
J Clin Endocrinol Metab. 2015; 100:342-362
32.
National Institute for Health and Clinical Excellence: Guidance
Obesity: identification, assessment and management of overweight and obesity in children, young people and adults: partial update of CG43. National Clinical Guideline Centre (UK).National Institute for Health and Care Excellence (UK), London, 2014
33.
Yumuk, V ∙ Frühbeck, G ∙ Oppert, JM ∙ et al.
An EASO position statement on multidisciplinary obesity management in adults
Obes Facts. 2014; 7:96-101
34.
Frühbeck, G ∙ Toplak, H ∙ Woodward, E ∙ et al., the European Association for the Study of Obesity
Need for a paradigm shift in adult overweight and obesity management - an EASO position statement on a pressing public health, clinical and scientific challenge in Europe
Obes Facts. 2014; 7:408-416
35.
Eckel, RH ∙ Jakicic, JM ∙ Ard, JD ∙ et al., the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
J Am Coll Cardiol. 2014; 63(25 Pt B):2960-2984
36.
Look AHEAD Research Group
Eight-year weight losses with an intensive lifestyle intervention: the look AHEAD study
Obesity (Silver Spring). 2014; 22:5-13
37.
Knowler, WC ∙ Fowler, SE ∙ Hamman, RF ∙ et al., the Diabetes Prevention Program Research Group
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study
Lancet. 2009; 374:1677-1686
38.
LeFevre, ML, the U.S. Preventive Services Task Force
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U.S. Preventive Services Task Force Recommendation Statement
Ann Intern Med. 2014; 161:587-593
39.
Anon. Decision memo for intensive behavioral therapy for obesity. (CAG-00423N). http://www.cms.gov/medicare-coverage-database/shared/handlers/highwire.ashx?url=http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx (accessed Jan 15, 2015).40.
Unick, JL ∙ Neiberg, RH ∙ Hogan, PE ∙ et al., the Look AHEAD Research Group
Weight change in the first 2 months of a lifestyle intervention predicts weight changes 8 years later
Obesity (Silver Spring). 2015; 23:1353-1356
41.
Gudzune, KA ∙ Doshi, RS ∙ Mehta, AK ∙ et al.
Efficacy of commercial weight-loss programs: an updated systematic review
Ann Intern Med. 2015; 162:501-512
42.
Johnston, BC ∙ Kanters, S ∙ Bandayrel, K ∙ et al.
Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis
JAMA. 2014; 312:923-933
43.
Thomas, DM ∙ Weedermann, M ∙ Fuemmeler, BF ∙ et al.
Dynamic model predicting overweight, obesity, and extreme obesity prevalence trends
Obesity (Silver Spring). 2014; 22:590-597
44.
Hall, KD ∙ Sacks, G ∙ Chandramohan, D ∙ et al.
Quantification of the effect of energy imbalance on bodyweight
Lancet. 2011; 378:826-837
45.
Siervo, M ∙ Lara, J ∙ Chowdhury, S ∙ et al.
Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis
Br J Nutr. 2014; 113:1-15
46.
Appel, LJ ∙ Moore, TJ ∙ Obarzanek, E ∙ et al., the DASH Collaborative Research Group
A clinical trial of the effects of dietary patterns on blood pressure
N Engl J Med. 1997; 336:1117-1124
47.
Estruch, R ∙ Ros, E ∙ Salas-Salvadó, J ∙ et al., the PREDIMED Study Investigators
Primary prevention of cardiovascular disease with a Mediterranean diet
N Engl J Med. 2013; 368:1279-1290
48.
Sacks, FM ∙ Bray, GA ∙ Carey, VJ ∙ et al.
Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates
N Engl J Med. 2009; 360:859-873
49.
Hu, T ∙ Mills, KT ∙ Yao, L ∙ et al.
Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials
Am J Epidemiol. 2012; 176(suppl 7):S44-S54
50.
Huo, R ∙ Du, T ∙ Xu, Y ∙ et al.
Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: a meta-analysis
Eur J Clin Nutr. 2014; 69:1200-1208
51.
Sacks, FM ∙ Carey, VJ ∙ Anderson, CA ∙ et al.
Effects of high vs low glycemic index of dietary carbohydrate on cardiovascular disease risk factors and insulin sensitivity: the OmniCarb randomized clinical trial
JAMA. 2014; 312:2531-2541
52.
Schwingshackl, L ∙ Hoffmann, G
Long-term effects of low glycemic index/load vs. high glycemic index/load diets on parameters of obesity and obesity-associated risks: a systematic review and meta-analysis
Nutr Metab Cardiovasc Dis. 2013; 23:699-706
53.
Tsai, AG ∙ Wadden, TA
The evolution of very-low-calorie diets: an update and meta-analysis
Obesity (Silver Spring). 2006; 14:1283-1293
54.
Jakicic, JM ∙ Egan, CM ∙ Fabricatore, AN ∙ et al., the Look AHEAD Research Group
Four-year change in cardiorespiratory fitness and influence on glycemic control in adults with type 2 diabetes in a randomized trial: the Look AHEAD Trial
Diabetes Care. 2013; 36:1297-1303
55.
Scottish Intercollegiate Guidelines Network
115 management of obesity
(accessed Aug 21, 2015).
56.
Wu, T ∙ Gao, X ∙ Chen, M ∙ et al.
Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis
Obes Rev. 2009; 10:313-323
57.
Slentz, CA ∙ Houmard, JA ∙ Kraus, WE
Exercise, abdominal obesity, skeletal muscle, and metabolic risk: evidence for a dose response
Obesity (Silver Spring). 2009; 17(suppl 3):S27-S33
58.
McTiernan, A ∙ Sorensen, B ∙ Irwin, ML ∙ et al.
Exercise effect on weight and body fat in men and women
Obesity (Silver Spring). 2007; 15:1496-1512
59.
Jakicic, JM ∙ Marcus, BH ∙ Gallagher, KI ∙ et al.
Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial
JAMA. 2003; 290:1323-1330
60.
Jakicic, JM ∙ Marcus, BH ∙ Lang, W ∙ et al.
Effect of exercise on 24-month weight loss maintenance in overweight women
Arch Intern Med. 2008; 168:1550-1559
discussion 1559–60
61.
Ross, R ∙ Hudson, R ∙ Stotz, PJ ∙ et al.
Effects of exercise amount and intensity on abdominal obesity and glucose tolerance in obese adults: a randomized trial
Ann Intern Med. 2015; 162:325-334
62.
Leslie, WS ∙ Hankey, CR ∙ Lean, ME
Weight gain as an adverse effect of some commonly prescribed drugs: a systematic review
QJM. 2007; 100:395-404
63.
Blumenthal, SR ∙ Castro, VM ∙ Clements, CC ∙ et al.
An electronic health records study of long-term weight gain following antidepressant use
JAMA Psychiatry. 2014; 71:889-896
64.
Anon
Adipex-P (phentermine) prescribing information
(accessed Feb 22, 2015).
65.
Anon
Xenical (orlistat) prescribing information
(accessed Feb 22, 2015).
66.
Anon
Belviq (lorcaserin) prescribing information
(accessed Feb 22, 2015).
67.
Anon
Qsymia (phentermine/topiramate ER) prescribing information
(accessed Feb 22, 2015).
68.
Anon
Contrave (naltrexone SR/bupropion SR) prescribing information
(accessed Feb 22, 2015).
69.
Anon
Saxenda (liraglutide 3.0 mg) prescribing information
(accessed Jan 18, 2015).
70.
Sjöström, L ∙ Rissanen, A ∙ Andersen, T ∙ et al., the European Multicentre Orlistat Study Group
Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients
Lancet. 1998; 352:167-172
71.
Chanoine, JP ∙ Hampl, S ∙ Jensen, C ∙ et al.
Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial
JAMA. 2005; 293:2873-2883
72.
Torgerson, JS ∙ Hauptman, J ∙ Boldrin, MN ∙ et al.
XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients
Diabetes Care. 2004; 27:155-161
73.
Smith, SR ∙ Weissman, NJ ∙ Anderson, CM ∙ et al., the Behavioral Modification and Lorcaserin for Overweight and Obesity Management (BLOOM) Study Group
Multicenter, placebo-controlled trial of lorcaserin for weight management
N Engl J Med. 2010; 363:245-256
74.
O'Neil, PM ∙ Smith, SR ∙ Weissman, NJ ∙ et al.
Randomized placebo-controlled clinical trial of lorcaserin for weight loss in type 2 diabetes mellitus: the BLOOM-DM study
Obesity (Silver Spring). 2012; 20:1426-1436
75.
Fidler, MC ∙ Sanchez, M ∙ Raether, B ∙ et al., the BLOSSOM Clinical Trial Group
A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: the BLOSSOM trial
J Clin Endocrinol Metab. 2011; 96:3067-3077
76.
Gadde, KM ∙ Allison, DB ∙ Ryan, DH ∙ et al.
Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial
Lancet. 2011; 377:1341-1352
77.
Aronne, LJ ∙ Wadden, TA ∙ Peterson, C ∙ et al.
Evaluation of phentermine and topiramate versus phentermine/topiramate extended-release in obese adults
Obesity (Silver Spring). 2013; 21:2163-2171
78.
Allison, DB ∙ Gadde, KM ∙ Garvey, WT ∙ et al.
Controlled-release phentermine/topiramate in severely obese adults: a randomized controlled trial (EQUIP)
Obesity (Silver Spring). 2012; 20:330-342
79.
Apovian, CM ∙ Aronne, L ∙ Rubino, D ∙ et al., the COR-II Study Group
A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II)
Obesity (Silver Spring). 2013; 21:935-943
80.
Hollander, P ∙ Gupta, AK ∙ Plodkowski, R ∙ et al., the COR-Diabetes Study Group
Effects of naltrexone sustained-release/bupropion sustained-release combination therapy on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes
Diabetes Care. 2013; 36:4022-4029
81.
Greenway, FL ∙ Fujioka, K ∙ Plodkowski, RA ∙ et al., the COR-I Study Group
Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial
Lancet. 2010; 376:595-605
82.
Wadden, TA ∙ Foreyt, JP ∙ Foster, GD ∙ et al.
Weight loss with naltrexone SR/bupropion SR combination therapy as an adjunct to behavior modification: the COR-BMOD trial
Obesity (Silver Spring). 2011; 19:110-120
published online June 17, 2010.
83.
Astrup, A ∙ Carraro, R ∙ Finer, N ∙ et al., the NN8022-1807 Investigators
Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide
Int J Obes (Lond). 2012; 36:843-854
84.
Wadden, TA ∙ Hollander, P ∙ Klein, S ∙ et al., the NN8022-1923 Investigators
Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study
Int J Obes (Lond). 2013; 37:1443-1451
85.
Pi-Sunyer, X ∙ Astrup, A ∙ Fujioka, K ∙ et al., the SCALE Obesity and Prediabetes NN8022-1839 Study Group
A randomized, controlled trial of 3.0 mg of liraglutide in weight management
N Engl J Med. 2015; 373:11-22
86.
Davies, MJ ∙ Bergenstal, R ∙ Bode, B ∙ et al., the NN8022-1922 Study Group
Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial
JAMA. 2015; 314:687-699
87.
Giddens, JM ∙ Sheehan, KH ∙ Sheehan, DV
The Columbia Suicidality severity rating scale (C-SSRS): has the gold standard become a liability?
Innov Clin Neurosci. 2014; 11:66-80
88.
Margulis, AV ∙ Mitchell, AA ∙ Gilboa, SM ∙ et al., National Birth Defects Prevention Study
Use of topiramate in pregnancy and risk of oral clefts
Am J Obstet Gynecol. 2012; 207:405
(e1–7).
89.
Angrisani, L ∙ Santonicola, A ∙ Iovino, P ∙ et al.
Bariatric Surgery Worldwide 2013
Obes Surg. 2015; 25:1822-1832
90.
Mechanick, JI ∙ Youdim, A ∙ Jones, DB ∙ et al., the American Association of Clinical Endocrinologists, Obesity Society, American Society for Metabolic & Bariatric Surgery
Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient–2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery
Endocr Pract. 2013; 19:337-372
91.
Sjöström, L ∙ Narbro, K ∙ Sjöström, CD ∙ et al., the Swedish Obese Subjects Study
Effects of bariatric surgery on mortality in Swedish obese subjects
N Engl J Med. 2007; 357:741-752
92.
Sjöström, L ∙ Peltonen, M ∙ Jacobson, P ∙ et al.
Bariatric surgery and long-term cardiovascular events
JAMA. 2012; 307:56-65
93.
Sjöström, L
Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery
J Intern Med. 2013; 273:219-234
94.
Dixon, JB ∙ le Roux, CW ∙ Rubino, F ∙ et al.
Bariatric surgery for type 2 diabetes
Lancet. 2012; 379:2300-2311
95.
Kashyap, SR ∙ Bhatt, DL ∙ Wolski, K ∙ et al.
Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: analysis of a randomized control trial comparing surgery with intensive medical treatment
Diabetes Care. 2013; 36:2175-2182
96.
Ikramuddin, S ∙ Korner, J ∙ Lee, WJ ∙ et al.
Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the diabetes surgery study randomized clinical trial
JAMA. 2013; 309:2240-2249
97.
Schauer, PR ∙ Bhatt, DL ∙ Kirwan, JP ∙ et al., the STAMPEDE Investigators
Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes
N Engl J Med. 2014; 370:2002-2013
98.
Mingrone, G ∙ Panunzi, S ∙ De Gaetano, A ∙ et al.
Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial
Lancet. 2015; 386:964-973
99.
Sjöström, L ∙ Peltonen, M ∙ Jacobson, P ∙ et al.
Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications
JAMA. 2014; 311:2297-2304
100.
Frühbeck, G
Bariatric and metabolic surgery: a shift in eligibility and success criteria
Nat Rev Endocrinol. 2015; 11:465-477
101.
Fried, M ∙ Yumuk, V ∙ Oppert, JM ∙ et al., the International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC), the European Association for the Study of Obesity (EASO), the European Association for the Study of Obesity Obesity Management Task Force (EASO OMTF)
Interdisciplinary European guidelines on metabolic and bariatric surgery
Obes Surg. 2014; 24:42-55
102.
Chang, SH ∙ Stoll, CR ∙ Song, J ∙ et al.
The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012
JAMA Surg. 2014; 149:275-287
103.
Tack, J ∙ Deloose, E
Complications of bariatric surgery: dumping syndrome, reflux and vitamin deficiencies
Best Pract Res Clin Gastroenterol. 2014; 28:741-749
104.
Brethauer, SA ∙ Kothari, S ∙ Sudan, R ∙ et al.
Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force
Surg Obes Relat Dis. 2014; 10:952-972
105.
Stegenga, H ∙ Haines, A ∙ Jones, K ∙ et al., for the Obesity Guideline Development Group (GDG)
Identification, assessment and management of overweight and obesity: summary of NICE guidance
BMJ. 2014; 349:g6608
106.
Dietz, WH ∙ Baur, LA ∙ Hall, K ∙ et al.
Management of obesity: improvement of health-care training and systems for prevention and care
Lancet. 2015; 385:2521-2533
107.
Phelan, SM ∙ Burgess, DJ ∙ Yeazel, MW ∙ et al.
Impact of weight bias and stigma on quality of care and outcomes for patients with obesity
Obes Rev. 2015; 16:319-326
108.
Frühbeck, G
Obesity: screening for the evident in obesity
Nat Rev Endocrinol. 2012; 8:570-572
109.
Blundell, JE ∙ Dulloo, AG ∙ Salvador, J ∙ et al., EASO SAB Working Group on BMI
Beyond BMI—phenotyping the obesities
Obes Facts. 2014; 7:322-328
110.
Ahima, RS ∙ Lazar, MA
Physiology. The health risk of obesity—better metrics imperative
Science. 2013; 341:856-858
111.
Kramer, CK ∙ Zinman, B ∙ Retnakaran, R
Are metabolically healthy overweight and obesity benign conditions?: A systematic review and meta-analysis
Ann Intern Med. 2013; 159:758-769
112.
Chang, Y ∙ Ryu, S ∙ Suh, BS ∙ et al.
Impact of BMI on the incidence of metabolic abnormalities in metabolically healthy men
Int J Obes (Lond). 2012; 36:1187-1194
113.
Gómez-Ambrosi, J ∙ Catalán, V ∙ Rodríguez, A ∙ et al.
Increased cardiometabolic risk factors and inflammation in adipose tissue in obese subjects classified as metabolically healthy
Diabetes Care. 2014; 37:2813-2821
114.
Gómez-Ambrosi, J ∙ Silva, C ∙ Galofré, JC ∙ et al.
Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity
Int J Obes (Lond). 2012; 36:286-294
115.
Lavie, CJ ∙ De Schutter, A ∙ Milani, RV
Healthy obese versus unhealthy lean: the obesity paradox
Nat Rev Endocrinol. 2015; 11:55-62
116.
Thow, AM ∙ Downs, S ∙ Jan, S
A systematic review of the effectiveness of food taxes and subsidies to improve diets: understanding the recent evidence
Nutr Rev. 2014; 72:551-565
Article metrics
Related Series
Copyright: Voisin/Phanie/Science Photo Library
Published: September 14, 2017
Obesity
Figure 1 Factors that predict weight loss in the Look AHEAD study36,40
Effect of physical activity (A), behaviour sessions (B), meal replacements (C) on weight loss. (D) Weight loss at years 4 and 8 after beginning the study is shown relative to percentage weight loss at 1 month and 2 months. Greater weight loss at 1 year is associated with greater proportion of visits attended, minutes per week of physical activity, and greater meal replacement use (A, B, C). The tertiles of weight ranges are shown below each set of bars.
Figure 2 Targets for anti-obesity drugs
White boxes indicate specific drugs located next to the target upon which they are acting. Inside the white boxes green names stand for already approved drugs, whereas red names represent drugs in phase 1–3 development. The right hand panel summarises the neurotransmitters and pathways in the CNS in energy homoeostasis, whereas the left hand panel represents the mechanisms operative in the periphery. The intermediate area represents where the effects of both central and peripheral actions converge—namely, on the two main components of the energy balance equation: energy intake and expenditure. Most of the approved drugs are working centrally where stimulation of the POMC/CART pathway has anorexigenic effects, whereas the NPY/AGRP pathway exerts orexigenic effects. The interaction with the several receptors present in neurones of the hypothalamus determines the balance between orexigenic and anorexigenic effects. Most of the drugs tested in clinical trials are aimed at peripheral systems. Thus, thyroid analogues and β3 adrenergic agonists induce thermogenesis by activation of brown adipose tissue, thereby increasing energy expenditure. Enzymes involved in lipid metabolism, such as DGAT, FAS, MetAP2, and NQO1 are also being targeted. The gut microbiome and the regulation of bile acids represent further targets to combat obesity. The lipase and SGLT2 inhibitors favour energy loss by the gastrointestinal and renal elimination of fat and glucose, respectively. Agonism of pancreatic and intestinal hormones like amylin and GLP-1 has also been shown to be useful for weight loss. DGAT1=diacylglycerol O-acyltransferase aminotransferase 1. PexRAP=peroxisomal reductase activating PPARγ. FAS=fatty acid synthase. MetAP2=methionyl aminopeptidase 2. NQO1=NAD(P)H dehydrogenase: quinone oxidoreductase 1. SGLT2=sodium-glucose-linked transporter 2. AGRP=agouti-related peptide POMC=proopiomelanocortin C. CART=cocaine amphetamine-related transcript. GHSR=growth hormone secretagogue receptor. GLP1R=glucagon-like peptide 1 receptor. α-MSH=α-melanocyte-stimulating hormone. MCH1R=melanin-concentrating hormone 1 receptor. MC3/4R=melanocortin receptor type 3/4. 5HT2c=serotonin receptor type 2c.
Supplementary appendix
