Obesity is the most prevalent and serious nutritional disease among western countries and is rapidly replacing undernutrition as the most common form of malnutrition in the world. Approximately 300,000 deaths a year are currently associated with overweight and obesity, second only to cigarette smoking as a leading cause of preventable death in the United States. Obesity effects 9 organ systems and is a risk factor for gastroesophageal reflux disease, nonalcoholic fatty liver disease, cholelithiasis, and colon cancer. Evidence-based guidelines on the identification, evaluation, and treatment of overweight and obesity have recently been developed by the National Institutes of Health to help practitioners effectively manage their patients. The body mass index is used to classify weight status and risk of disease. Treatment for obesity includes lifestyle management, consisting of diet therapy, physical activity, and behavioral modification, and may include pharmacotherapy or surgery based on level of risk.Currently only 2 medications, sibutramine and orlistat, are approved for long-term use. An initial weight loss of 10% of body weight achieved over 6 months is a recommended target. This article reviews the evaluation and management of the adult obese patient.
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机译：肥胖是西方国家中最普遍，最严重的营养疾病，并且正在迅速取代营养不良，成为世界上最常见的营养不良形式。目前，每年约有30万人死于超重和肥胖，仅次于吸烟是美国可预防的死亡的主要原因。肥胖会影响9个器官系统，并且是胃食管反流病，非酒精性脂肪肝，胆石症和结肠癌的危险因素。美国国立卫生研究院（National Institutes of Health）最近制定了有关鉴定，评估和治疗超重和肥胖的循证指南，以帮助从业人员有效地管理患者。体重指数用于分类体重状况和疾病风险。肥胖症的治疗包括生活方式管理，包括饮食治疗，体育锻炼和行为改变，并可能根据风险程度进行药物治疗或手术。目前仅批准长期使用两种药物西布曲明和奥利司他。推荐的目标是在6个月内使体重减轻10％。本文回顾了成人肥胖患者的评估和治疗。
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