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
