Skip to main content

Advertisement

SpringerLink
Log in

The management of adult obesity

  • Original Research Paper
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Obesity is Canada’s most prevalent metabolic disease: one-third of Canadians are obese. It is a major cause of type 2 diabetes, hypertension, hyperlipidaemia, and atherosclerosis. The treatment of disease caused by obesity accounts for an estimated 2.4 percent of Canada’s health care expenditures for all diseases (1.8 billion dollars in 1997). This article presents a treatment algorithm based on a number of international guidelines and aimed to help physicians play a more active role in the management of adult obesity. Two problems are briefly examined: pregnancy and stopping cigarettes smoking.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Reeder B.A., Angel A., Ledoux M., Rabkin S.W., Young T.K., Sweet L.E.: Obesity and its relation to cardiovascular disease risk factors in Canadian adults. Canadian Heart Health Surveys Research Group. C.M.A.J., 146, 2009–2019, 1992.

    CAS  Google Scholar 

  2. Rabkin S.W., Chen Y., Leiter L., Liu L., Reeder B.A.: Risk factor correlates of body mass index. Canadian Heart Health Surveys Research Group. C.M.A.J., 157 (Suppl. 1), S26–S31, 1997.

    Google Scholar 

  3. Despres J.P., Moorjani S., Lupien P.J., Tremblay A., Nadeau A., Bouchard C.: Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis, 10, 497–511, 1990.

    Article  PubMed  CAS  Google Scholar 

  4. Birmingham C.L., Muller J.L., Palepu A., Spinelli J.J., Anis A.H.: The cost of obesity in Canada. C.M.A.J., 160, 483–488, 1999.

    CAS  Google Scholar 

  5. Lee K.M.N., Jonat L.M., Birmingham C.L.: Obesity diagnosis and treatment algorithm. Br. Columbia Med. J., 44, 126–130, 2002.

    Google Scholar 

  6. Birmingham C.L., Jones P.: Clinical nutrition: How much should patients eat? Can. Med. Assoc. J., 166, 767–770, 2002.

    Google Scholar 

  7. Fortier M.D., Katzmarzyk P.T., Malina R.M., Bouchard C.: Seven-year stability of physical activity and musculoskeletal fitness in the Canadian population. Med. Sci. Sports Exerc., 33, 1905–1911, 2001.

    Article  PubMed  CAS  Google Scholar 

  8. Spanier P.A., Allison K.R.: General social support and physical activity: an analysis of the Ontario Health Survey. Can. J. Public Health, 92, 210–213, 2001.

    PubMed  CAS  Google Scholar 

  9. Pi-Sunyer F.X.: Obesity: criteria and classification. Proc. Nutr. Soc., 59, 505–509, 2000.

    Article  PubMed  CAS  Google Scholar 

  10. Douketis J.D., Feightner J.W., Attia J., Feldman W.F.: Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity. Canadian Task Force on Preventive Health Care. C.M.A.J., 160, 513–525, 1999.

    CAS  Google Scholar 

  11. Dobbelsteyn C.J., Joffres M.R., MacLean D.R., Flowerdew G.: A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys. Int. J. Obes. Relat. Metab. Disord., 25, 652–661, 2001.

    Article  PubMed  CAS  Google Scholar 

  12. Lean M.E., Han T.S., Seidell J.C.: Impairment of health and quality of life in people with large waist circumference. Lancet, 351, 853–856, 1998.

    Article  PubMed  CAS  Google Scholar 

  13. Anand S.S., Yusuf S., Vuksan V., Devanesen S., Teo K.K., Montague P.A., Kelemen L., Yi C., Lonn E., Gerstein H., Hegele R.A.: Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet 356, 279–284, 2000.

    Article  PubMed  CAS  Google Scholar 

  14. Katzmarzyk P.T., Malina R.M.: Obesity and relative subcutaneous fat distribution among Canadians of First Nation and European ancestry. Int. J. Obes. Relat. Metab. Disord., 22, 1127–1131, 1998.

    Article  PubMed  CAS  Google Scholar 

  15. Sarkin J.A., Johnson S.S., Prochaska J.O., Prochaska J.M.: Applying the transtheoretical model to regular moderate exercise in an overweight population: validation of a stages of change measure. Prev. Med., 33, 462–469, 2001.

    Article  PubMed  CAS  Google Scholar 

  16. Blundell J.E., Gillett A.: Control of food intake in the obese. Obes. Res., 9 (Suppl 4), 263S–270S, 2001.

    Article  PubMed  CAS  Google Scholar 

  17. Clinical Guidelines on the Identification, evaluation, and treatment of overweight and obesity in adults: The evidence report. National Institutes of Health. Obes. Res., 6 (Suppl. 2), 51S–209S, 1998.

    Google Scholar 

  18. Force AAOT. AACE/ACE position statement on the prevention, diagnosis, and treatment of obesity. Endocrine Practice 4, 297–330, 1998.

    Google Scholar 

  19. Network S.I.G.: Obesity in Scotland: Integrating Prevention with Weight Management: A National Clinical Guideline recommended for use in Scotland by the Scottish Intercollegiate Guidelines Network. Edinburgh, SIGN, 1996.

    Google Scholar 

  20. Sullivan M.K.J,. Sjostrom L., Backman L., Bengtsson C., Bouchard C., Dahlgren S., Jonsson E., Larsson B., Lindstedt S.: Swedish obese subjects (SOS): an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int. J. Obes. Relat. Metab. Disord., 17, 503–512, 1993.

    PubMed  CAS  Google Scholar 

  21. Rossi S.R., Rossi J.S., Rossi-DelPrete L.M., Prochaska J.O., Banspach S.W., Carleton R.A.: A process of change model for weight control for participants in community-based weight loss programs. Int. J. Addict., 29, 161–177, 1994.

    PubMed  CAS  Google Scholar 

  22. Bray G.A., Tartaglia L.A.: Medicinal strategies in the treatment of obesity. Nature, 404, 672–677, 2000.

    PubMed  CAS  Google Scholar 

  23. Glazer G.: Long-term pharmacotherapy of obesity 2000: a review of efficacy and safety. Arch. Intern. Med., 161, 1814–1824, 2001.

    Article  PubMed  CAS  Google Scholar 

  24. Hauner H.: Current pharmacological approaches to the treatment of obesity. Int. J. Obes. Relat. Metab. Disord., 25 (Suppl 1), S102–S106, 2001.

    Article  PubMed  CAS  Google Scholar 

  25. Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement. Am. J. Clin. Nutr., 55 (2 Suppl), 615S–619S, 1992.

    Google Scholar 

  26. Guidelines for laparoscopic and open surgical treatment of morbid obesity. Am. Soc. Bariatric Surgery. Society of American Gastrointestinal Endoscopic Surgeons. Obes. Surg., 10, 378–379, 2000.

    Google Scholar 

  27. Anderson J.W., Konz E.C., Frederich R.C., Wood C.L.: Long-term weight-loss maintenance: a meta-analysis of US studies. Am. J. Clin. Nutr., 74, 579–584, 2001.

    PubMed  CAS  Google Scholar 

  28. Davidson M.H., Hauptman J., DiGirolamo M., Foreyt J.P., Halsted C.H., Heber D., Heimburger D.C., Lucas C.P., Robbins D.C., Chung J., Heymsfield S.B.: Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. JAMA, 281, 235–242, 1999.

    Article  PubMed  CAS  Google Scholar 

  29. Mun E.C., Blackburn G.L., Matthews J.B.: Current status of medical and surgical therapy for obesity. Gastroenterology, 120, 669–681, 2001.

    Article  PubMed  CAS  Google Scholar 

  30. Blundell J.E., King N.A.: Physical activity and regulation of food intake: current evidence. Med. Sci. Sports Exerc., 31 (11 Suppl), S573–S583, 1999.

    PubMed  CAS  Google Scholar 

  31. Kincade D., Birmingham C.L.: Weight loss in women. J. Soc. Obstetricians and Gynaecologists of Canada, 21, 434–438, 1999.

    Google Scholar 

  32. Kincaide D., Birmingham C.L.: Weight loss in pregnancy. J. Soc. Obstetricians and Gynaecologists of Canada 21, 440–444, 1999.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Eating Disorders Program, St. Paul’s Hospital, University of British Columbia, 1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6

    C. L. Birmingham

  2. School of Dietetics and Human Nutrition, University of McGill, Canada

    P. Jones

  3. Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada

    L. J. Hoffer

Authors
  1. C. L. Birmingham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. J. Hoffer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. L. Birmingham.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Birmingham, C.L., Jones, P. & Hoffer, L.J. The management of adult obesity. Eat Weight Disord 8, 157–163 (2003). https://doi.org/10.1007/BF03325006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03325006

Key words

Search

Navigation