The prevention and treatment of metabolic syndrome and high-risk obesity.
OBJECTIVE
The prevalence of obesity is increasing at an alarming rate, and the obesity epidemic is driving the epidemic in type 2 diabetes. High-risk obesity is characterized by abdominal obesity with evidence of abnormal glucose and lipid metabolism, and a state of heightened inflammation.


RESULTS
With increasing body weight, lipid accumulation occurs not only in adipose tissue, but in other organs as well. This 'lipotoxicity' in liver, muscle, islets, and elsewhere may account for many of the features of the metabolic syndrome. Adipose tissue produces many proteins, some of which are inflammatory cytokines, and others of which are antiinflammatory or which improve insulin sensitivity.


CONCLUSIONS
The treatment of obesity requires the identification of the high-risk patient, and the institution of lifestyle measures with a long-term outlook, and an avoidance of heavily marketed fads. Current research will likely lead to improved medications in the future.
Molavi
Behzad
B
The Central Arkansas Veterans Healthcare System, Arkansas 72205, USA. molavibehzad@uams.edu
Rasouli
Neda
N
Kern
Philip A
PA
D000273:Adipose Tissue / Q000378:metabolism; D019440:Anti-Obesity Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism; D050528:Diet, Carbohydrate-Restricted; D006801:Humans; D008019:Life Style; D050356:Lipid Metabolism / Q000502:physiology; D024821:Metabolic Syndrome / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control* / Q000628:therapy*; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000517:prevention & control* / Q000628:therapy*; D012307:Risk Factors
D019440:Anti-Obesity Agents