Obesity Prevention and Treatment Lifestyle Medicine Series Editor James M. Rippe Founder and Director, Rippe Lifestyle Institute Professor of Medicine, University of Massachusetts Medical School Led by James M. Rippe, MD, Founder and Director, Rippe Lifestyle Institute, this series is directed to a broad range of researchers and professionals consisting of topical books with clinical applications in nutrition and health, physical activity, obesity management, and applicable subjects in lifestyle medicine. Increasing Physical Activity A Practical Guide James M. Rippe Manual of Lifestyle Medicine James M. Rippe Obesity Prevention and Treatment A Practical Guide James M. Rippe and John P. Foreyt For more information, please visit: www.routledge.com/Lifestyle-Medicine/book- series/CRCLM Obesity Prevention and Treatment A Practical Guide Edited by James M. Rippe, MD Founder and Director, Rippe Lifestyle Institute Professor of Medicine, University of Massachusetts Medical School John P. Foreyt, PhD Professor, Department of Medicine, Baylor College of Medicine First edition published 2022 by CRC Press 6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742 and by CRC Press 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN © 2022 selection and editorial matter, James M. Rippe and John P. Foreyt; individual chapters, the contributors CRC Press is an imprint of Taylor & Francis Group, LLC Reasonable eforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. Te authors and p ublishers have attempted to trace the copyright holders of all material r eproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microflming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, access www.copyright.com or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. For works that are not available on CCC please contact [email protected] Trademark notice: Product or corporate names may be trademarks or registered trademarks and are used only for identifcation and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Rippe, James M., editor. | Foreyt, John Paul, editor. Title: Obesity prevention and treatment : a practical guide / edited by James M. Rippe, John P. Foreyt. Description: Boca Raton : CRC Press, 2022. | Includes bibliographical references and index. | Summary: “Te World Health Organization estimates that there are 2.1 billion individuals with obesity globally. Nearly three quarters of adults in the United States are overweight or obese. Te average individual with obesity cuts ten years of their life expectancy, yet less than 40% of p hysicians routinely counsel individuals concerning the adverse health consequences of obesity. Obesity Prevention and Treatment: A Practical Guide equips healthcare practitioners to include efective weight management counselling in the daily practice of medicine. Written by lifestyle medicine pioneer and cardiologist, Dr. James Rippe and obesity expert Dr. John Foreyt, this book provides evidence-based discussions of obesity and its metabolic consequences. A volume in the Lifestyle Medicine Series, it provides evidence-based information about the prevention and treatment of o besity through lifestyle measures, such as regular physical activity and sound nutrition, as well as the use of new medications or bariatric surgery available to assist in weight management. Provides a framework and practical strategies to assist practitioners in safe and efective treatments of obesity. Contains information explaining the relationship between obesity and increased risk of heart disease, diabetes, cancer, osteoarthritis, and other chronic conditions. Chapters begin with bulleted key points and conclude with a list of Clinical Applications. Written for practitioners at all levels, this user-friendly, evidence-based book on obesity prevention and treatment will be valuable to practitioners in general medicine or subspecialty practices”— Provided by publisher. Identifers: LCCN 2021017357 (print) | LCCN 2021017358 (ebook) | ISBN 9780367551780 (paperback) | ISBN 9780367567187 (hardback) | ISBN 9781003099116 (ebook) Subjects: MESH: Obesity—prevention & control | Obesity—therapy | Obesity—complications | United States Classifcation: LCC RC628 (print) | LCC RC628 (ebook) | NLM QU 248 AA1 | DDC 616.3/98—dc23 LC record available at https://lccn.loc.gov/2021017357 LC ebook record available at https://lccn.loc.gov/2021017358 ISBN: 9780367567187 (hbk) ISBN: 9780367551780 (pbk) ISBN: 9781003099116 (ebk) DOI: 10.1201/9781003099116 Typeset in Times by codeMantra Dedication To my family, Stephanie, Hart, Jaelin, Devon and Jamie Rippe. Their love and support make all of these endeavors possible and worthwhile. In memory of Julian Davis and Sam Cunningham, two of Dr. Foreyt’s earliest clinical mentors, who both recently passed away, at ages 99 and 96, respectively, for their lifelong friendship. They will always be in my thoughts and prayers. Contents Preface.......................................................................................................................xi Acknowledgments ....................................................................................................xv Editors ....................................................................................................................xvii Contributors ............................................................................................................xix Section i the Modern Management of obesity Chapter 1 Preventing and Managing Obesity: The Scope of the Problem ...........3 James M. Rippe, MD Chapter 2 The Pathophysiology of Obesity ........................................................ 13 James M. Rippe, MD Chapter 3 The Epidemiology of Adult Obesity .................................................. 21 James M. Rippe, MD Chapter 4 Identifcation, Evaluation, and Treatment of Overweight and Obesity................................................................................................29 James M. Rippe, MD Chapter 5 Exercise Management for the Patient with Obesity ........................... 43 James M. Rippe, MD Chapter 6 Behavioral Management for the Patient with Obesity ....................... 53 John P. Foreyt, PhD Chapter 7 Dietary Management of Overweight and Obesity ..............................63 Nina Crowley, PhD, RDN, LD, and Katherine R. Arlinghaus, PhD, RD Chapter 8 A Clinical Approach to Pharmacological Management of the Patient with Obesity ........................................................................... 75 Magdalena Pasarica, MD, PhD and Nikhil V. Dhurandhar, PhD, FTOS vii viii Contents Chapter 9 Bariatric Surgery ................................................................................95 Robert F. Kushner, MD Chapter 10 Pediatric Obesity .............................................................................. 113 James M. Rippe, MD Chapter 11 A diposity-Based Chronic Disease: A New Diagnostic Term ........... 123 James M. Rippe, MD Section ii obesity and Specifc Medical conditions Chapter 12 Obesity and Cardiovascular Disease ................................................ 135 James M. Rippe, MD Chapter 13 Obesity and Diabetes ........................................................................ 151 James M. Rippe, MD Chapter 14 Obesity and the Metabolic Syndrome .............................................. 165 James M. Rippe, MD Chapter 15 Lifestyle Approaches Targeting Obesity to Lower Cancer Risk, Progression, and Recurrence ............................................................ 175 James M. Rippe, MD Chapter 16 Obesity and Arthritis ........................................................................ 187 James M. Rippe, MD Section iii Future Directions and Public Health issues Chapter 17 Beyond Subcutaneous Fat ................................................................ 197 James M. Rippe, MD Contents ix Chapter 18 Public Health and Obesity ................................................................207 James M. Rippe, MD Chapter 19 Future Directions in Obesity and Weight Management ................... 215 James M. Rippe, MD Index ......................................................................................................................225