Prevention of Overweight and Obesity

Obesity is now a true epidemic and public health crisis that both clinicians and patients must face. Normal body weight is defined as a body mass index (BMI), calculated as the weight in kilograms divided by the height in meter squared, of < 25 kg/m2; overweight is defined as a BMI = 25.0-29.9 kg/m2, and obesity as a BMI > 30 kg/m2. Over the last several years, the prevalence of obesity in the US population, the prevalence of obesity in the US population has increased dramatically. Among US adults, rates of obesity have risen from 15.9% in 1995 to 26.7% in 2008. Among men, the prevalence of obesity increased significantly between 1995 (16.5%) and 2008 ( 27.4%). A similar trend was seen among women between 1995 (14.7%) and 2008 (25.6%). There is a significant variation in rates of obesity by race. Between 2006 and 2008 blacks (35.7%) had 51% greater prevalence of obesity and Hispanics (28.7%) had 21% greater prevalence when compared with non Hispanic whites (23.7%). This trend has been linked both to declines in physical activity and to increased caloric intake in diets rich in fats and carbohydrates.

   Adequate levels of physical activity appear to be important for the preventation of weight gain and the development of obesity. Despite this, only 49% of Americans are physically active at a moderate level, and 20% at at a more vigorous level.In addition, only 3% of Americans meet four of the five recommendations for the intake of grains, fruits, vegetables, dairy products, and meat of the Food Guide Pyramid. Only one of four Americans eats the recommended five or more fruits and vegetables per day.

  Prevention of overweight and obesity involves both increasing physical activity and dietary modification to reduce caloric intake. Clinicians can help guide patients to develop personalized eating plans to reduce energy intake, particularly by recognizing the contributions of fat, concentrated carbohydrates, and large portion sizes. Patients typically underestimate caloric content, especially when consuming food away from home. Providing Patients with caloric and nutritional information may help address the current obesity epidemic. To prevent the long-term chronic disease sequelae of over weight or obesity, clinicians must work with patients to modify other risk factors, eg, by smoking cessation and strict glycemic and blood pressure control.

  Clinicians seem to share a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research demonstrates that approximately 20% of overweight individuals are successful at long-term weight loss (defined as losing greater than 10% of initial body weight and maintaining the loss for greater than 1 year).The development and implementation of innovative public health strategies is essential in the fight against obesity, Lessons learned from smoking cessation campaigns may be helpful in the battle against this significant public health concern