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38 - Obesity

Published online by Cambridge University Press:  12 January 2010

By
John G. Kral
Edited by
Michael F. Lubin ,
Robert B. Smith ,
Thomas F. Dodson ,
Nathan O. Spell  and
H. Kenneth Walker
John G. Kral
Affiliation:
SUNY Downstate Medical Center, Brooklyn, New York
Michael F. Lubin
Affiliation:
Emory University, Atlanta
Robert B. Smith
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Nathan O. Spell
Affiliation:
Emory University, Atlanta
H. Kenneth Walker
Affiliation:
Emory University, Atlanta
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Summary

Introduction

The increasing prevalence of obesity among adults and children, new insights into the pathogenesis of obesity, and significant changes in the practice of surgery through adoption of less traumatic laparoscopic approaches, all justify up-dating this chapter from the third edition (published in 1995, containing references through 1993).

Prevalence

The age-adjusted prevalence of obesity was 30.5% in 2000 according to a national examination survey, while the prevalence of overweight was 64.5%. The largest telephone survey in the USA reported a prevalence of 20.9% for obesity in 2000 giving an indication of the validity of telephone surveys related to this topic. Regardless of their relative validity, all studies unequivocally document disturbingly rapid yearly increases (P < 0.001) in obesity and overweight and their related serious diseases: diabetes, hypertension, dyslipidemia, asthma, etc. Class 3 obesity (BMI ≥ 40) tripled from 1990 to 2000, reaching a prevalence of 6% among black women, causing the authors of the study to conclude: “the incidence of various diseases will increase substantially in the future.” Increasing prevalences of childhood and adolescent overweight and obesity are especially troubling: adolescent overweight is a strong predictor of adult illness.

Two large epidemiological studies published in January 2003 comprising 3457 subjects (The Framingham Heart Study) and 23 659 subjects confirmed that obesity and overweight in adulthood markedly decrease life expectancy. Fontaine et al. determined that younger adults generally had greater number of years lost than did older adults and Peeters et al. found the decreases in life expectancy to be comparable to those seen with smoking.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
 , pp. 465 - 478
Publisher: Cambridge University Press
Print publication year: 2006

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