The growing problem of obesity: mechanisms, consequences, and therapeutic approaches.

Abstract

Obesity is a significant problem in the United States and worldwide and one that is not sufficiently abating despite extensive entreaties in the press and in public service announcements. Hence, great attention has been paid to understanding obesity—from its epidemiology, pathobiology, and to therapeutic approaches. To optimally interpret published reports on obesity, it is necessary to adhere to the definitions of the term. The Centers for Disease Control (CDC) define obesity according to criteria aligned directly with subject age. Specifically, in infants and toddlers (age range, birth to age 2 years), high weight for recumbent length is defined as weight for length at or above the 95th percentile of the sex-specific CDC growth charts. In the age range from 2 to 19 years, obesity is defined as body mass index (BMI) at or above the sex-specific CDC BMI-for-age growth charts, and in subjects age>19 years, obesity is defined as BMI≥30.1 Based on these definitions, the CDC reported that the percentage of individuals meeting the definition of obesity in 2011 to 2012 within these specific age ranges was 8.1%, 16.9%, and 34.9%, respectively.1 In addition to the potential for great toll on health and self-esteem, the associated complications of obesity, such as type 2 diabetes mellitus, cardiovascular disease, stroke, and certain forms of cancer, impose a high burden on healthcare delivery.2 The CDC reported that in 2008, the cost of obesity was $147 billion. Notably, the medical costs for those with obesity were $1429 greater annually than for those who were not classified as obese.3 Of significant concern, the rise in obesity in young people seems to carry significant complications when diabetes mellitus ensues, such as increased levels of low-density lipoprotein cholesterol, hypertension, retinopathy, and microalbuminuria that, although comparable with rates observed in obese adults, seems to …