The Obesity Epidemic

The prevalence of obesity is increasing at an alarming rate and with it the occurrence of a number of comorbidities, including cardiovascular disease, type 2 diabetes, stroke, and certain types of cancer. Approximately one third of adults in the US population are currently classified as obese. Globally, >400 × 106 adults are classified as obese, a number that is expected to double by 2015. Consequently, obesity and its associated health problems are placing a large burden on an already overwhelmed healthcare system. The worldwide costs attributable to this disease are estimated to be between 0.7% and 2.8% of total healthcare expenditures. Furthermore, medical costs for obese individuals are substantially higher than for nonobese people.Obesity is a multifactorial disease caused by a chronic energy surplus in which energy intake exceeds energy expenditure, leading to the accumulation of excess adipose tissue. Regulation of energy homeostasis is a complex process, and that fact imparts a considerable challenge in trying to elucidate the pathogenesis of obesity. Although poor lifestyle choices, including inappropriate diets and lack of physical activity, undoubtedly play a large role, genetic susceptibility also puts an individual at increased risk.The majority of obesity therapies have been aimed at behavior modification and pharmacologic intervention, although to date these therapies have led to only modest weight loss. Although less common, bariatric surgery has led to substantial long-term weight loss in morbidly obese patients; this type of treatment, however, is both invasive and costly.Given the growing trend of obesity in both developed and developing countries, considerable importance has been placed on increasing awareness of the problem. In this article, 4 leaders in the field of obesity provide their opinions on obesity and discuss the latest advancements in pathogenesis, therapy, prevention, and the use of novel biomarkers to identify those at risk …