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Obesity

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Key Points ÎThe Task Force agrees with the opinion of prominent medical societies that current scientific evidence supports the view that obesity is a disease. ÎWeight loss produces many benefits including risk factor improvement, prevention of disease, and improvements in feeling and function. Greater weight loss produces greater benefits, but modest (5%–10%) weight loss, such as that produced by lifestyle modifications and medications, has been shown to produce significant improvements in many conditions. ÎMedications used for the management of conditions other than obesity can contribute to or exacerbate weight gain in susceptible individuals. Many of these conditions are also associated with obesity. ÎHealth care providers can help patients prevent or attenuate weight gain by appropriately prescribing medications that would promote weight loss or minimize weight gain when treating these conditions. ÎHealth care providers can help selected patients successfully lose weight and maintain lost weight by appropriately prescribing weight loss medications or in some cases surgical intervention as an adjunct to lifestyle change. Table 1. Causes of Obesity Primary Causes Genetic causes Monogenic disorders • Melanocortin-4 receptor mutation • Leptin deficiency • Pro-opiomelanocortin deficiency Syndromes • Prader-Willi • Bardet-Biedl • Cohen • Alström • Froehlich Secondary Causes Neurologic • Brain injury • Brain tumor • Consequences of cranial irradiation • Hypothalamic obesity Endocrine • Hypothyroidism a • Cushing syndrome • Growth hormone deficiency • Pseudohypoparathyroidism Psychological • Depression b • Eating disorders Drug-Induced • Tricyclic antidepressants • Oral contraceptives • Antipsychotics • Anticonvulsants • Glucocorticoids • Sulfonylureas • Glitazones • β-Blockers a Controversial whether hypothyroidism causes obesity or exacerbates obesity. b Depression associated with overeating or binging. Diagnosis

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