1st Edition

A Guide to Obesity and the Metabolic Syndrome Origins and Treatment

By George A. Bray Copyright 2011
    412 Pages 80 B/W Illustrations
    by CRC Press

    412 Pages 80 B/W Illustrations
    by CRC Press

    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.

    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?


    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.