The problem of obesity: fundamental concepts of energy metabolism gone awry.

The growing prevalence and complex issues related to obesity continue to draw the interest and concern of health researchers and practitioners. This review summarizes pertinent background information on the multiple factors involved in the causes of obesity. Factors such as percentage of body fat, upper- vs. lower-body obesity, family history, past dieting history, and underlying medical conditions should be assessed on an individual basis and applied in the development of successful weight-reducing strategies. The recommended approach to nonpharmacologic intervention for weight loss is to first educate individuals about fat storage and energy balance and then focus on the development of positive behavioral skills such as wise food selections, favorable eating patterns, and regular physical activity. Although preventive measures such as positive eating patterns and exercise habits are ideally acquired in childhood and adolescence, successful weight management can still be achieved in adulthood. The information presented in the following sections provides clinicians with essential material to assist individuals in developing realistic goals at the outset of a weight-control program.