title: Advances in the Science, Treatment, and Prevention of the Disease of Obesity: Reflections From a Diabetes Care Editors' Expert Forum.
abstract: As obesity rates increase, so too do the risks of type 2 diabetes, cardiovascular disease, and numerous other detrimental conditions. The prevalence of obesity in U.S. adults more than doubled between 1980 and 2010, from 15.0 to 36.1%. Although this trend may be leveling off, obesity and its individual, societal, and economic costs remain of grave concern. In June 2014, a Diabetes Care Editors' Expert Forum convened to review the state of obesity research and discuss the latest prevention initiatives and behavioral, medical, and surgical therapies. This article, an outgrowth of the forum, offers an expansive view of the obesity epidemic, beginning with a discussion of its root causes. Recent insights into the genetic and physiological factors that influence body weight are reviewed, as are the pathophysiology of obesity-related metabolic dysfunction and the concept of metabolically healthy obesity. The authors address the crucial question of how much weight loss is necessary to yield meaningful benefits. They describe the challenges of behavioral modification and predictors of its success. The effects of diabetes pharmacotherapies on body weight are reviewed, including potential weight-neutral combination therapies. The authors also summarize the evidence for safety and efficacy of pharmacotherapeutic and surgical obesity treatments. The article concludes with an impassioned call for researchers, clinicians, governmental agencies, health policymakers, and health-related industries to collectively embrace the urgent mandate to improve prevention and treatment and for society at large to acknowledge and manage obesity as a serious disease.
authors.forename: William T
authors.initials: WT
authors.lastname: Cefalu
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.forename: Philip D
authors.initials: PD
authors.lastname: Home
authors.forename: W Timothy
authors.initials: WT
authors.lastname: Garvey
authors.forename: Samuel
authors.initials: S
authors.lastname: Klein
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Pi-Sunyer
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Itamar
authors.initials: I
authors.lastname: Raz
authors.forename: Luc
authors.initials: L
authors.lastname: Van Gaal
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Wolfe
authors.forename: Donna H
authors.initials: DH
authors.lastname: Ryan
mesh_terms: D000328:Adult; D019440:Anti-Obesity Agents / Q000627:therapeutic use; D050110:Bariatric Surgery / Q000379:methods; D001521:Behavior Therapy / Q000379:methods; D001835:Body Weight / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005544:Forecasting; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology / Q000517:prevention & control; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss
chemical_list: D019440:Anti-Obesity Agents; D007004:Hypoglycemic Agents