点击显示 收起
Minnesota Obesity Center
1 Veterans Drive
Minneapolis, MN 55417
E-mail: aslevine{at}umn.edu
The treatment of obesity is not a simple task. Relatively few books are available that can be used as a guide for both bariatric physicians and general practitioners in the prevention and management of this major health problem. Bray and Bouchard present a new edition of their Handbook of Obesity, now divided into 2 volumes: one dealing with the etiology, prevalence, and consequences of obesity and the other addressing the evaluation and treatment of obesity. The latter volume has been subtitled Clinical Applications and serves as a primer and reference book for those treating the obese or those conducting applied obesity research. The book is organized into 3 sections with 18 chapters: 4 chapters address evaluation, 4 focus on prevention, and 10 deal with treatment. The well-published authors of this edited book represent >20 institutions and express diverse solutions for the evaluation, prevention, and treatment of obesity.
The section on evaluation begins with Bray's chapter that teaches us the taxonomy of obesity, both in terms of anatomy and etiology; he discusses dealing with changes in body weight through the life cycle, ways to interview a patient, and algorithms for clinical evaluation. Kushner and Aronne address the primary care physician's responsibility in caring for obese patients, and a uniquely important chapter by Kumanyika focuses on the attention needed to care for ethnically diverse overweight populations. Puhl and Brownell summarize the prejudice and discrimination that obese persons face in settings ranging from schools to the legal system.
The section on prevention begins with James and Gill's chapter that addresses obesity prevention and the need to use targeted strategies for high-risk groups (eg, persons with abdominal obesity), susceptible ethnic groups, adolescents, and those with comorbidities. Swinburn and Egger point out how and why the environments in which people live help produce obesity. Grundy describes how a person can prevent 2 of the comorbidities associated with obesity, the metabolic syndrome and dyslipidemia, through lifestyle changes as well as drug therapy. Yanovski and Stunkard review the classic eating disorders by examining the diagnostic criteria, epidemiology, pathophysiology, symptoms, and treatment of these ailments; this knowledge base is important to the general practitioner as well as the bariatrician.
The treatment of obesity is thoroughly discussed in the remaining 10 chapters. Scholarly discussions of behavioral approaches to obesity including classic and contemporary programs (Wing), the use of exercise for obesity treatment (Miller and Wadden), prevention of weight regain (Perri and Foreyt), and surgery (Sjostrom) are presented. Several chapters dealing with drug therapy include reviews of the sympathomimetic and serotonergic drugs (Bray and Ryan), absorption- or metabolism-altering drugs (Van Gaal and Bray), work with leptin from the bench to the bedside (Caro and Considine), thermogenesis-altering drugs (Astrup and Toubro), newly emerging targets or drugs (Jung and Bray), and herbal or alternative approaches (Greenway and Heber).
The splitting of this handbook into 2 volumes was a wise decision, particularly in light of the information explosion and the need for materials for the ever-expanding number of clinicians treating obesity and its comorbidities. The volume on clinical application is well integrated, has superb tables and figures to summarize complex materials, and includes discussions of most of the important issues for the practitioner and student of obesity.