A Guide to Obesity and the Metabolic Syndrome: Origins and Treatment, 1st Edition (Paperback) book cover

A Guide to Obesity and the Metabolic Syndrome

Origins and Treatment, 1st Edition

By George A. Bray

CRC Press

412 pages | 80 B/W Illus.

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In the historical record there is abundant evidence that obesity was a medical and health concern as long as medicine has been practiced. The idea of diet and exercise are bulwarks in the fight against obesity in history from the time of Hippocrates to the 16th century—a span of 2,000 years. However, our scientific understanding of this problem is only a little over 200 years old. An examination of the root cause of what many consider the obesity epidemic,A Guide to Obesity and the Metabolic Syndrome traces the origins and types of obesity and its treatment.

Examining in detail the developing treatment for obesity, this book provides:

  • A history of obesity, including treatment, proposed causes, and perceptions
  • An examination of the causes and problems associated with obesity
  • A discussion of lifestyle, diet, exercise, and treatment strategies
  • A detailed look at the medications and surgeries available for obesity

The fact that we have an epidemic of obesity today that is covering the globe suggests that the strategically simple ideas of eating less and exercising more, ideas that require commitment and personal involvement by the individual, have not been very successful. As we move forward in trying to understand this problem, we need to be alert to strategies and tactics that may not require individual motivation and commitment—history has shown that they do not work well. This book supplies guidance on developing and designing novel strategic interventions against obesity and metabolic disorders.

Table of Contents


Origins of Obesity in the Scientific Era—AD 1500 to the Present


Sixteenth Century

Seventeenth Century

Eighteenth Century

Nineteenth Century

Twentieth Century: An Age of Specialization in Science and Medicine

Definition, Measurement, and Prevalence



Describing Body Composition

Methods of Measuring Body Weight and Body Fat

Instruments Used to Measure Body Composition

Instrumental Methods for Measuring Visceral Fat

Body Fat through the Life Span

Body Fat and Body Energy Stores

Criteria for the Metabolic Syndrome

Prevalence of Obesity

Metabolic Syndrome


Genetic, Metabolic, and Social Origins of Obesity


Genetic Factors

Epigenetic and Intrauterine Imprinting

Environmental Agents and Obesity: An Epidemiologic Approach

Regulation of Body Fat: A Homeostatic Model of Energy Regulation

Effects of Obesity on Health and Metabolism


Historical Context for the Risks of Overweight as a Disease

Costs of Obesity

The Pathology of Obesity

The Pathophysiology of Central and Total Fat

Benefits and Potential Risks of Weight Loss


Prevention, Evaluation, and Introduction to Treatment


Prevention of Obesity

Introduction to Treatment

Criteria for Evaluating Outcomes

Lifestyle, Diet, and Exercise: Cognitive Solutions

Introduction to Cognitive Solutions for Weight Loss

Lifestyle Change: A Cognitive Solution

Diet: A Cognitive Solution

Physical Activity: A Cognitive Solution

Cognitive Strategies to Maintain Weight Loss

Medications for Obesity

Brief History of the Drug Treatment for Obesity

Mechanisms that Modulate Food Intake and Energy Expenditure: The Basis for Pharmacological Interventions

Drugs Approved by the Food and Drug Administration for the Treatment of Obesity

Drugs Approved for Other Uses that Have Effects on Body Weight

Combinations of Drugs Used for Weight Loss

Drugs in Late Stages of Clinical Evaluation

Concepts for Antiobesity Drugs in Earlier Stages of Development

Complementary and Herbal Medicine

Surgery for Obesity


Rationale for Surgical Intervention for Obesity



Bariatric Surgery for Pediatric Patients

Effectiveness of Surgical Procedures

Mechanisms for Weight Loss

Benefits from Bariatric Surgery


Other Procedures

Postscript—Obesity in the Twenty-First Century

Lessons We Have Learned in this Book

Where Do We Go in the Twenty-First Century?

About the Author

George A. Bray, M.D., MACP, MACE is a Boyd Professor at the Pennington Biomedical Research Center of Louisiana State University in Baton Rouge, Louisiana, and Professor of Medicine at the Louisiana State University Medical Center in New Orleans. He was the first Executive Director of the Pennington Biomedical Research Center in Baton Rouge, a post he held from 1989 to 1999. He is a Master in both the American College of Physicians and the American College of Endocrinology. Dr. Bray founded the North American Association for the Study of Obesity (NAASO now The Obesity Society), and he was the founding editor of its journal, Obesity Research, as well as co-founder of the International Journal of Obesity and the first editor of Endocrine Practice, the official journal of the American College of Endocrinologists.

Dr. Bray has received many awards during his medical career. They have included the Johns Hopkins Society of Scholars, Honorary Fellow, American Dietetic Association, Joseph Goldberger Award from the American Medical Association, the McCollum Award from the American Society of Clinical Nutrition and the Osborne-Mendel Award from the American Society of Nutritional. Dr. Bray has also received the TOPS Award from NAASO, the Weight Watchers Award, the Bristol-Myers Squibb Mead Johnson Award in Nutrition and the Stunkard Lifetime Achievement Award. During the past 40 years, Dr. Bray has authored or coauthored more than 1,700 publications, ranging from peer-reviewed articles to reviews, books, book chapters and abstracts.

Subject Categories

BISAC Subject Codes/Headings:
MEDICAL / Endocrinology & Metabolism
MEDICAL / Nutrition
MEDICAL / Public Health