Rethinking our approach to the obese patient: Time to create the obesity treatment score

摘要

In 2012, there is no doubt that the global impact of obesity is enormous. The pandemic dimension of this complex metabolic feature of human evolution transcends pathophysiology; obesity influences socioeconomics, politics, and culture. On the surface, obesity is a simple matter of too much body fat, too much food, and too little exercise. Pondering further, obesity involves more complicated mechanisms of appetite control, insulin resistance, inflammation, and cardiometabolic disease. Our environment and our bodies are interconnected, and in the face of an overabundance of food, our genes react to store adipose tissue. Clinical practice guidelines base decisions on metrics directly related to body fat mass and distribution. Interventions are lifestyle, pharmacotherapy, or surgery. Notwithstanding behavioral barriers, this is pretty straightforward.