Challenges in obesity management

Obesity is increasing at an alarming rate. During the past decade, the overall prevalence of obesity in the United States increased over 30%, with more than one third of the adult population meeting the definition of being overweight. We review current and emerging therapies, present outcome data from a large clinical practice, and discuss challenges for physicians and researchers involved in obesity treatment. Because obesity is a risk factor for numerous medical disorders and excess mortality, it is imperative that effective treatments be developed. While the current conservative therapies produce short-term weight losses, they are ineffective in the long term. Some obesity treatments are controversial, most notably the increasing use of anorexiant medications. For example, the Food and Drug Administration (FDA) recently requested the withdrawal of two widely used medications because of concerns about side effects. Currently, therapies that combine psychosocial interventions, drugs, and extended maintenance appear to have the most promising long-term benefits. Long-term treatment, including extended pharmacotherapy, may be necessary for many obese patients. Broader definitions of treatment outcome and success, including improvements in comorbid conditions, physical activity, and quality of life are needed.