Centuries ago the tendency for an organism to survive was closely if not completely tied to the availability of food. Over eons mankind has taken at least tenuous control of his environment, certainty making his caloric needs an easy task to complete. Truly, during no time in recorded history was the availability of quality food more plentiful, the selection greater, or the medical risks of Obesity less prevalent!

What is obesity? In 1985 the National Institutes of Health in response to the continual growth in girth of the American Populus announced criteria for the measurement of obesity. Based upon their statistical analysis of the American population along with other epidemiologic factors NIH set forth criteria that outline those individuals with weight problems that transcend casual overweight and become medically significant. According to NIH an individual who is up to 10% above ideal weight is simply overweight. An individual who is 20% or more above ideal weight is by NIH definition suffering from Medical Obesity and noted it at that point to be a disease. More than 100 pounds or 100% above ideal weight is Morbid Obese and represents a level at which significant comorbidities develop. These ratings are rather arbitrary, however, their findings are significant as they reflect the points at which medical risk factors such as hypertension, diabetes, stroke, and cardiac disease begin to increase several fold.

Recently, researchers at the Rockefeller Institute isolated “the fat gene” in laboratory rats. Literally, thousands of dollars have been spent to breed “Fat Rats” or so called “Zucker Rats” to attempt to isolate causes, and develop possible treatments for  eventual use in man. Unfortunately, we are still at the early stages of discovery as far as to the exact cause of obesity in humans. Research is promising and clearly in the not to distant future, more specific causes and treatments will be available. The true answer as to who gets obesity is, just about anyone in whom their intake of calories exceeds the number of calories expended. Certainly, there is a genetic component, and individuals with family history of Obesity are at even greater risk of developing the disease. More importantly anyone is at risk of developing the disease and at this time the official status is that Obesity can be treated and controlled but is considered incurable!

Why is obesity dangerous? Because it kills. Probably the most prevalent disease in the US overweight (> 10% above ideal weight) is encounter in six out of ten adults, obesity (> 20% above ideal weight) is found in four out of ten and recent findings indicate 1 individual in ten is morbidly obese. There is a report that a new heading of Super Morbid obesity >200% or 200 pounds above ideal weight is being considered. Obesity kills by increasing the risks of damage to the cardiovascular system, liver, as well as increasing the development of  Diabetes, Colon Cancer and exacerbating Arthritis. Almost daily, additional risks are associated with increased girth. Pulmonary disease, increased incidence of infection, and is associated with increased Clinical and Sub-Clinical Depression.

Obesity treatment is fraught with failures, and individuals almost never keep weight off long term. Extremely resistant, obesity is a life long disorder that due to it’s recidivism has invited a host of treatment methods, some of which even today are extreme and dangerous as well as being ineffective. Stomach stapling, Intestinal By-passes, Jaw Wiring as well as, Herbal Enemas, Food Allergies, Liquid Fasts, Milk Shakes, Cookies, Vitamins Injections, Amphetamines, Hypnosis and a host of bazaar, sometimes fatal and ineffective treatments have been tried in the treatment hope of procuring a cure. Obesity is a desperate disease. Owing to the social pressures imposed by our society, people so afflicted tend to go to any length to gain control, many times subjecting themselves to life threatening risks. The October 1997 manufactures recall of Phen/Fen & Redux, Much to the financial dismay of the plethora of Phen/Fen clinics that have now come and gone, after being prescribed to 18,000,000+ “guinea pig patients” is a prime example of the overzealousness on the part of both the physician and the patients in attempting to gain control of this disorder.

As is apparent, Obesity is still being treated with less than spectacular results. Current effective treatment methods must include exercise, behavior modification and dietary changes with which the individual can live. Unrealistic goals and diets beyond the realm of reality are ineffective and destined to fail from the beginning. Although there are some hopeful magic bullet medications on the horizon these may be many years away and may be too little too late for those individuals now in need.

The future of Obesity treatment may offer hope from several different approaches. Genetic manipulation and phenotypic controls may become more readily available in the next 10 to 20 years.

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