Clinical Obesity in Adults and Children

– what works for weight loss maintenance, and when Relationship between quantity of intentional weight loss and weight maintenance success Weight maintenance in those postbariatric surgery Weight loss maintenance post pharmacologically assisted weight loss Weight maintenance using Intermittent weight loss LELD approaches Clinical and commercial approaches for weight loss maintenance Conclusion References 24 Training and Medical Systems for Obesity Care The current state of obesity knowledge and care Medical education Provider training and competencies Obesity medicine education collaborative competencies Medical licensure Obesity medicine as a specialty Systems of care for obesity Summary References

12 5 Childhood Obesity 25 The Prevention of Childhood Obesity Introduction Obesity prevention in clinical settings Early childhood Schools Behavior change interventions in communities Policy interventions in communities Country‐level Initiatives Sugary drink taxes Novel approaches to obesity prevention Criteria for the selection of prevention strategies Summary References 26 Consequences of Childhood and Adolescent Obesity Seeing the child and youth in context Comparing the consequences of obesity, and obesity as a causal factor of chronic health conditions Conclusion References 27 The Treatment of Childhood and Adolescent Obesity Introduction Approach to the child with obesity Treatment overview Treating obesity as a chronic disease Behavioral interventions Motivational interviewing and primary care counseling to modify lifestyle behaviors Comprehensive multidisciplinary obesity treatment Specific dietary modifications Pharmacotherapy Information systems Conclusions References

13 6 Policy Approaches 28 Policy Approaches to Obesity Prevention Early interest in obesity policy: the 1970s and 1980s Ecological determinants of obesity: the 1990s and early 2000s Global development and systems approach: the early 2000s Targets and “best buys” in the early 2010s From best buys to regulating commerce: the later 2010s A sustainable political economy of health: the 2020s The political economy of obesity: building a sustainable response Conclusion References 29 The Double Burden of Malnutrition Introduction Scope of the problem and prevalence Dynamics of the double burden Early childhood development amidst double burden malnutrition Conclusion Acknowledgments References 30 Taxes, Subsidies, and Policies Introduction Food environments and dietary determinants Impact on dietary patterns and health Breastfeeding practices Interventions in healthcare settings Marketing restrictions for unhealthy products References 31 The Global Syndemic of Obesity, Undernutrition, and Climate Change Background Malnutrition in all its forms The Global Syndemic Policy inertia Systems thinking approach to the Global Syndemic Double‐ and triple‐duty actions Applying systems approaches – cities Applying systems approaches – communities References

14 Index

15 End User License Agreement

1 Chapter 2 Table 2.1 Select sources of data on trends in obesity for the United States ... Table 2.2 Cut‐offs for defining excess body fat using anthropometric measure... Table 2.3 Prevalence of obesity in adults by region and sex, 2016

2 Chapter 4 Table 4.1 Pleiotropic genetic obesity syndromes Table 4.2 Monogenic obesity syndromes affecting the leptin‐melanocortin path...

3 Chapter 7Table 7.1 Obesogenic built environment features as assessed by the Spotlight...Table 7.2 Association of built environment features related to physical acti...

4 Chapter 8Table 8.1 Variables identified in the obesity systems map organized by doma...

5 Chapter 10Table 10.1 Adipokines, the effects on their target organs and the net effect...Table 10.2 IDF consensus on waist circumference cut‐off for different ethnic...Table 10.3 Clinically usable parameters to estimate VAT.

6 Chapter 12Table 12.1 Maternal and offspring complications of obesity

7 Chapter 13Table 13.1 Studies of the independent association of MAFLD, including previo...Table 13.2 Efficacy of sodium‐glucose cotransporter 2 (SGLT2) inhibitors in ...Table 13.3 Efficacy of glucagon‐like peptide 1 (GLP1) receptor agonists in p...

8 Chapter 14Table 14.1 Risk pathways that may explain links between excess adiposity and...Table 14.2 A summary of key pieces of evidence from epidemiology, genetics, ...

9 Chapter 15Table 15.1 Definitions in sleep‐disordered breathingTable 15.2 Sleepiness in the patients with obesityTable 15.3 Symptoms of sleep‐disordered breathing

10 Chapter 17Table 17.1 Classification of overweight and obesity in adults and the cut‐of...Table 17.2 Benefits of 5–10% weight loss (Ref)Table 17.3 Goals of obesity managementTable 17.4 Treatment modalities for obesityTable 17.5 Practical approach to obesity treatment – clinical assessment and...Table 17.6 Essential elements for the management of overweight and obesityTable 17.A.1 Clinical history of a person with obesity – key pointsTable 17.A.2 Drug treatment which may be associated with weight gainTable 17.A.3 Measures that can be taken at home

11 Chapter 18Table 18.1 Recommendations and clinical guidelines for the management of obe...

12 Chapter 19Table 19.1 FDA‐approved anti‐obesity medications for chronic weight manageme...

13 Chapter 20Table 20.1 Studies showing the impact of exercise duration on weight loss re...Table 20.2 Studies showing the impact of exercise EE on weight loss response...

14 Chapter 21Table 21.1 Principles of prescribing in obesity [12,17].

15 Chapter 22Table 22.1 Results from a systematic review of reports of bariatric procedur...Table 22.2 Studies of survival benefits of weight loss surgery

16 Chapter 23Table 23.1 Commonly reported weight loss maintenance definitionsTable 23.2 Characteristics of successful weight loss maintainers

17 Chapter 24Table 24.1 Provider training organizations and education organizations invol...Table 24.2 Obesity Medicine Education Collaborative core domains and associa...

18 Chapter 27Table 27.1 Evidence‐based behaviorsTable 27.2 Likely but unproven benefit, low harm behaviorsTable 27.3 Treatment intensity and BMI reduction in randomized controlled tr...Table 27.4 Bariatric surgery eligibility critiera [88].

19 Chapter 28Table 28.1 Interventions recommended by WHO in 2013

20 Chapter 30Table 30.1 Types of taxesTable 30.2 The case of Mexico

21 Chapter 31Table 31.1 Criteria for a whole of systems approach, related systems dynamic...

1 Chapter 1 Figure 1.1 Obesity prevalences in different regions of the world. Data for m... Figure 1.2 The prevalences of obesity in men and women in cohorts with over ... Figure 1.3 The relationship between the prevalences of obesity and diabetes ... Figure 1.4 An illustration of the principal factors leading to the obesity e... Figure 1.5 The global burden of disease assessed in terms of disability‐adju... Figure 1.6 The McKinsey Global Institute’s economic analysis of the social b...

2 Chapter 2 Figure 2.1 Prevalence of obesity (body mass index ≥30 kg/m 2) among adults in... Figure 2.2 World map of the prevalence of adult obesity (age 20+ years) in 2... Figure 2.3 World map of the prevalence of childhood obesity in girls (a) and... Figure 2.4 World map of the prevalence of childhood obesity in girls (a) and...

3 Chapter 3 Figure 3.1 Lifecourse view of noncommunicable disease risk. Figure 3.2 Associations of maternal pre‐pregnancy BMI and gestational weight... Figure 3.3 Association of Mediterranean diet score in pregnancy with child B... Figure 3.4 Association of maternal number of cigarettes smoked per day and r...

4 Chapter 4 Figure 4.1 Clinical response to leptin therapy in congenital leptin deficien... Figure 4.2 Changes in energy intake and expenditure in two children with con... Figure 4.3 Leptin therapy is associated with pulsatile gonadotropin secretio... Figure 4.4 Hypothalamic pathways regulating body weight.

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