Obesity: A Review of Pathogenesis and Management Strategies

Abstract

The prevalence of obesity in the developed world is increasing. Approximately 23% of adult Canadians (5.5 million people) are obese. Obesity is associated with an increased risk of developing several comorbid diseases, ranging from cardiovascular diseases to cholelithiasis and nonalcoholic fatty liver disease. The etiology of obesity is multifactorial, involving a complex interaction among genetics, hormones and the environment. The available evidence and recommendations for nonpharmacological management of obesity, including dietary therapy, physical activity and behavioural therapy, in addition to pharmacotherapy are discussed. A brief discussion on endoscopic and surgical procedures is undertaken. Several antiobesity treatment options are available and may be indicated in appropriate situations. Selecting obesity therapy may be guided by body mass index measurements, comorbid illnesses and patient preference.

Biological effects of bariatric surgery on obesity-related comorbidities

“…1 Obese patients are further categorized into class I (BMI 30-34.9), class II (BMI 35-39.9) and class III (BMI 40 or more). 2,3 While these subcategories are relevant when analyzing trends in prevalence, evidence suggests that the risk of chronic disease increases progressively from a BMI as low as 21. 1 In addition, the risk of obesity-related comorbidities increases in individuals with a large waist circumference, even if they are categorized as healthy or overweight.…”

“…[5][6][7] However, when comparing the distribution of BMI in [1976][1977][1978][1979][1980] with that in [2005][2006], it appears that the distribution among adults has shifted, reflecting a change in prevalence of superobesity In Canada, statistics from 2004 demonstrated that about 23% (5.5 million people) of adults were obese compared with 14% in the late 1970s. 2,8 The total direct cost of obesity in Canada has been estimated to be more than $1.8 billion, which corresponded to 2.4% of the total health care expenditures for all diseases in Canada in 1997. 9 When the cost of obesity-related comorbidities was taken into account, the 3 largest contributors were hypertension ($656.6 million), type 2 diabetes mellitus (T2DM; $423.2 million) and coronary artery disease ($346.0 million).…”

Obesity: Development, Epidemiology, Factors Affecting, Quantity, Health Hazards, Management and Natural Treatment-a Review

“…Rimonabant reduces food intake by blocking CB1r and enhances thermogenesis. Side effects include mood changes, nausea, vomiting, diarrhea, headache, dizziness and anxiety [102].…”

Obesidade ante et post cirurgia

“…A obesidade está, relacionada com um tipo de vida sedentária (Kaila et al, 2008). A ausência de actividade física origina uma maior acumulação energética, podendo ser um factor decisivo para o desenvolvimento da obesidade (Mota e Sallis, 2002).…”

“…A maioria dos estudos conclui que os pacientes activos perdem mais peso do que aqueles que continuam a levar uma vida sedentária após a cirurgia (Livhits et al, 2010). Indubitavelmente, a obesidade está relacionada com uma vida sedentária (Kaila et al, 2008). O exercício físico ajuda a prevenir o excesso de massa gorda e traz consigo benefícios físicos e psicológicos (Nunes, 2006).…”