Obesity and Gastroenterology

Overweight and obesity have emerged as major threats to public health all over the world. The 2013 Burden of Disease Study demonstrated that the worldwide proportion of women with a body mass index >25 grew from 30% in 1980 to 38% in 2013, while for men the proportion grew from 29 to 37% during the same time period. In the United States, overweight and obesity have reached epidemic proportions in 2015 with nearly 70% of adults and 30% of children having a body mass index that falls into one of these categories. Although countries associated with high income have historically had the highest prevalence, the prevalence of overweight and obesity is rising in countries of low and middle incomes. Given the far-reaching effects of obesity on health and disease, understanding the causes, consequences, and best management approaches is critical in all fields of medicine today.

This issue of Gastroenterology Clinics of North America illustrates the growing complexity of obesity by reviewing the physiology and behavioral and socioeconomic issues that contribute to its pathogenesis while placing emphasis on gastrointestinal and liver diseases. The latest therapies are included, covering a spectrum of behavioral approaches, pharmacologic interventions, endoscopic and surgical procedures, and manipulation of the gut microbiota to optimize metabolism and energy utilization. The treatment of overweight and obesity should be integrated into any therapeutic strategy when dealing with common chronic gastrointestinal and liver disorders, including gastroesophageal reflux, gallstones, fatty liver disease, and pancreatic disease. Practical advice is provided in these articles by experts to help those interested in utilizing evidence-based dietary, behavioral pharmacologic, and surgical approaches, or wishing to overcome the obstacles of managing childhood obesity.

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