Weight Control

The mechanisms controlling body weight or, to be more specific, that component of body mass that consists of adipose tissue is an active area of scientific research. Two stimuli can be discerned that give a sense of urgency to this research. The first is the data, from many sources, confirming an inexorable upward trend in the prevalence of overweight and obesity in developed countries. The picture in the emerging nations is unclear because of both a lack of appropriate survey data and the continued scourge of under­ nourishment among their poor. It is likely, however, that, throughout the world, wherever disposable income and food availability are high, obesity and overweight will be a continuing and increasing problem. The second driving force among researchers is the realization that, to date, there has been little success in either stemming the tide of individuals experiencing excessive adiposity or enabling them to recover a more desirable body weight and composition. Such are the problems. But significant progress in research into the origins and treatment of this condition is being made, and in recent years has been brisk. Technical advances (such as the ability to measure total energy expenditure in free-living individuals with good reliability), new and imaginative thinking and a determination not to be satisfied with hypotheses until they have been thoroughly challenged by experiment have yielded significant advances.

1. Disease risks of obesity. - The fallacy of ideal body weight standards. - Obesity and diabetes: many as yet unanswered questions. - Present public health issues on obesity. - References. - 2. Are all calories equal? . - Possible mechanisms by which calories from macronutrients might not be equal. - Are all calories equal for slimmers? . - `Are all calories equal? . - References. - 3. Metabolic risk factors for the development of obesity. - Determinants of energy expenditure. - Low metabolic rate as a risk factor. - The effect of dietary fat/carbohydrate on energy expenditure. - Oxidative autoregulation. - Diet composition and obesity. - Conclusion. - References. - 4. Metabolic response to slimming. - Short-term consequences of slimming. - Long-term consequences of slimming. - Conclusions. - References. - 5. Health effects of weight cycling. - The metabolic hypothesis. - Weight cycling and health. - Interpretation of epidemiological findings. - Psychological factors. - Conclusions and implications. - References. - 6. Food preferences and body weight control. - Food preferences and obesity. - Fat intake and fat preference in the genesis of obesity. - Genetic predisposition. - References. - 7. Psychological aspects of obesity. - Early psychological theories. - Emergence of the restrained eater. - Restrained eating and obesity. - Bulimia nervosa. - Strict control and the disturbance of eating behaviour. - Counter-regulation. - Individual variability. - Dietary macronutrient selection and body weight control. - Successful and unsuccessful weight control strategies. - References. - 8. Realistic expectations of obesity treatments. - No new treatment principles. - A pessimistic view. - Why so little success? . - Realistic strategies. - The definition of success. - An optimistic view. - References. - 9. Health professionalapproach to weight control. - Hypocaloric diet. - Exercise. - Pharmacotherapy. - Very low-calorie diets. - Surgery. - References.