title: Benefits of reducing--revisited.
abstract: The major premise by which weight reduction is used as a medical therapy is the fact that obesity is a primary risk factor in the onset and severity of many medical diseases. Hypertension, coronary artery disease, adult onset diabetes mellitus, complications of major abdominal and thoracic surgery, cancer of the breast and colon, and degenerative joint disease are prevalent diagnoses. The data to support weight reduction use as a medical therapy derive primarily from studies of cardiovascular disease. These studies show lowering of blood pressure and reduction of risk factors for glucose intolerance, angina, and hyperlipidaemia. The magnitude of weight loss (percent reduction in excess body weight) is important; 10 per cent reduction is a firm threshold in obese patients (greater than 130%- less than 200% ideal body weight). Success at achieving this medical therapy is most frequent using very low calorie diets which average 30-40% reduction of excess body weight. Mild and moderate hypertension will respond in 90% of patients. Type II diabetes mellitus patients can become free of exogenous insulin requirement. Response to general anaesthesia and control of respiratory distress syndrome will improve if preoperative weight loss is achieved. Improved cardiovascular fitness and relief of exertional dyspnoea are other clinically important outcomes of very low calorie diet therapy. A high priority exists to investigate the use of comprehensive professional weight control therapy as medical treatment.
mesh_terms: D001835:Body Weight; D006332:Cardiomegaly / Q000209:etiology; D003920:Diabetes Mellitus / Q000209:etiology; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000209:etiology; D006973:Hypertension / Q000209:etiology; D008297:Male; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000401:mortality