Etiology and treatment of obesity: Understanding a serious, prevalent, and refractory disorder.

Abstract

Obesity remains a leading public health problem because of its complications, prevalence, and resistance to change, despite record rates of dieting. Risk factors exist at both population and individual levels, thus obesity has diverse etiologies and consequences. Dieting is often grounded in the notion that the body can be molded at will and that the rewards justify the effort, creating a drive for unrealistic goals. This article argues for establishing a "reasonable weight," which may differ from health and aesthetic ideals. Intervention is less a matter of finding a "best" treatment but of finding the approach with "best fit" for the individual. Advances in treatment are most likely when research is driven by theory on the etiology of weight gain, the relapse process, and methods for permanent behavior change. This article integrates information on etiology, social beliefs about body weight, theory, and treatment into a comprehensive and compassionate model for intervention.

Cites (9)

1. In search of how people change: Applications to addictive behaviors.
   Prochaska, James O., DiClemente, Carlo C., Norcross, John C. · 1992 · American Psychologist
2. An Adoption Study of Human Obesity
   Stunkard, Albert J., Sørensen, Thorkild I.A., Hanis, Craig, Teasdale, Thomas W., Chakraborty, Ranajit, Schull, William J., Schulsinger, Fini · 1986 · New England Journal of Medicine
3. The Body-Mass Index of Twins Who Have Been Reared Apart
   Stunkard, Albert J., Harris, Jennifer R., Pedersen, Nancy L., McClearn, Gerald E. · 1990 · New England Journal of Medicine
4. Reduced Rate of Energy Expenditure as a Risk Factor for Body-Weight Gain
   Ravussin, Eric, Lillioja, Stephen, Knowler, William C., Christin, Laurent, Freymond, Daniel, Abbott, William G.H., Boyce, Vicky, Howard, Barbara V., Bogardus, Clifton · 1988 · New England Journal of Medicine
5. Determinants of 24-hour energy expenditure in man. Methods and results using a respiratory chamber.
   Ravussin, E, Lillioja, S, Anderson, T E, Christin, L, Bogardus, C · 1986 · Journal of Clinical Investigation
6. Changes in Plasma Lipids and Lipoproteins in Overweight Men during Weight Loss through Dieting as Compared with Exercise
   Wood, Peter D., Stefanick, Marcia L., Dreon, Darlene M., Frey-Hewitt, Barbara, Garay, Susan C., Williams, Paul T., Superko, H. Robert, Fortmann, Stephen P., Albers, John J., Vranizan, Karen M. et al. · 1988 · New England Journal of Medicine
7. Binge eating and dietary restraint in obese patients
   Marcus, Marsha D., Wing, Rena R., Lamparski, Danuta M. · 1985 · Addictive Behaviors
8. Improving long-term weight loss: pushing the limits of treatment
   Brownell, Kelly D., Jeffery, Robert W. · 1987 · Behavior Therapy
9. Evaluation of an alternating-calorie diet with and without exercise in the treatment of obesity
   Hill, J O, Schlundt, D G, Sbrocco, T, Sharp, T, Pope-Cordle, J, Stetson, B, Kaler, M, Heim, C · 1989 · The American Journal of Clinical Nutrition

Show all 9 references

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   Avenell, A, Broom, J, Brown, T, Poobalan, A, Aucott, L, Stearns, S, Smith, W, Jung, R, Campbell, M, Grant, A · 2004 · Health Technology Assessment
4. Relapse Prevention for Alcohol and Drug Problems: That Was Zen, This Is Tao
   Witkiewitz, Katie, Marlatt, G. Alan · 2004 · American Psychologist
5. Psychological correlates of obesity: Moving to the next research generation.
   Friedman, Michael A., Brownell, Kelly D. · 1995 · Psychological Bulletin

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