Addressing Overweight and Obesity: Evolving to a Medical Consensus. J Am Osteopath Assoc 2008;108(2_suppl_1):S2–S15. doi: .
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Rising rates of obesity and the resultant increase in associated cardiometabolic morbidity and mortality provided impetus for a roundtable discussion by an expert panel of physicians, physician assistants, and other scientists. Panel members reached a consensus concluding that obesity itself, as defined by waist circumference and the presence of comorbidities, is a disease that should be recognized and addressed with appropriate therapy. Their consensus is based on discussion including evidence that supports obesity, particularly central obesity, best measured by waist circumference, as a risk factor for cardiometabolic diseases. Waist circumferences greater than 102 cm (>40 inches) for men and greater than 88 cm (>35 inches) for women portend high risk. The expert panel endorses three levels of options for management: lifestyle modification, pharmacotherapy, and surgery. Panel members recommend the use of antiobesity agents and acknowledge that the benefits outweigh the risks associated with surgical procedures for obesity. They also point to the need to develop risk stratification guidelines for intervention targeting obesity as a disease.
any deviation from or interruption of the normal structure or function of any part, organ, or system (or combination thereof) of the body that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown.
Obesity is a disease that is characterized by increased fat cell size and increased adipokine release, with multiorgan involvement that increases the risk of diabetes and cardiovascular disease. Genetic predisposition triggered by metabolic and endocrine abnormalities of and in adipocytes eventually leads to end-organ dysfunction, including diabetes, coronary heart disease, hypertension, dyslipidemia, stroke, endothelial dysfunction, some cancers, nonalcoholic fatty liver disease, proteinuria, pulmonary hypertension, muscle insulin resistance, pancreatic insufficiency, gallbladder disease, and osteoarthritis.
Obesity, as defined by waist circumference, is a disease for which patients should be treated by a multifaceted approach that must include lifestyle modification and may include medical or surgical intervention.
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