Published on 06/06/2015 by admin

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Last modified 06/06/2015

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15 Obesity

Obesity is currently one of the most significant health problems in the United States, and the prevalence of this disease is increasing worldwide. A combination of metabolic, genetic, environmental, behavioral, and social factors affects a person’s risk for developing obesity. As the epidemic of obesity increases, there is a concomitant increase in the comorbid diseases associated with obesity, such as diabetes, hypertension, dyslipidemia, nonalcoholic fatty liver disease, sleep apnea, and orthopedic problems.

It is estimated that approximately 15% of children in the United States meet the criteria for being obese. The prevalence of obesity is greatest in children of African-American, Native American, and Mexican American descent. Preventing and treating obesity involve balancing caloric intake with energy expenditure. This basic concept is increasingly difficult in our society given the availability of inexpensive, high-calorie foods and the relatively sedentary lifestyle of most children.

Etiology and Pathogenesis

The causes of obesity are multifactorial, with both genetic and environmental influences playing roles in the balance between caloric intake and energy expenditure. Patients with at least one obese biologic parent have a threefold increased risk of developing obesity in their lifetime; having two obese biologic parents is associated with a 10-fold increased risk for developing obesity. Rarely, a genetic syndrome or endocrine disease contributes to the cause of a patient’s obesity. Examples of these disorders include Prader-Willi syndrome, Cushing’s disease, and hypothyroidism. Evaluation for these causes should be based on physical examination findings and history.