Alternative therapies for obesity: Benefit or rip-off [Review]

摘要

Obesity is a major public health problem in most industrialized countries because of its increasing prevalence and association with serious medical diseases. In the United States, 97 million adults are overweight (body mass index between 25.0 and 29.9 kg/m~2) or obese (body mass index > 30.0 kg/m~2). However, obesity is different than most other chronic diseases. In contrast to other diseases that can remain hidden in a patient's medical record, the presence of obesity is obvious to everyone. In addition, obesity is still viewed as a lack of control and incurs ill-will, discrimination, and prejudice rather than compassion and understanding. Therefore, most people who are obese are particularly anxious to become thinner to improve their health, be more acceptable to society, and improve their quality of life. Approximately one-third of men and one-half of women in the United States report that they are actively trying to lose weight and 33 billion dollar per year are spent on these efforts. Moreover, obese persons will accept extraordinary consequences to lose weight and maintain weight loss. In one study of post-obese subjects, nearly all participants would rather have a leg amputated or become blind than regain their lost weight. We have found that patients enrolled in our own weight management program would accept a 6 percent chance of immediate death if they could achieve their desired body weight and a fourth of our patients would accept a 21 percent chance of immediate death to reach this weight (Weiss B, Klein S and Nease R, unpublished observations).