Reprint: 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults.

Obesity is a chronic, multifactor disease with sizeable socio sanitary and economic consequences and is an issue in public health, mostly in developing countries. It causes or exacerbates a large number of health problems: diabetes, coronary heart disease, hypertension, and the incidence of certain cancers. It has been linked to a greater risk of cardiovascular mortality, a higher prevalence of psychopathology disorders and social maladjustment with a higher health care cost and shorter life-expectancy. In Spain, nowadays, the prevalence of overweight and obesity is nearly 50% of population. SEEN has developed a Clinical Practice Guide on diagnosis, evaluation and treatment of overweight and obesity in adult people with two sections: 1) Definition and classification of adult obesity, its epidemiology, etiopathogeny, complications, benefits of weight reduction and clinical evaluation of patients with overweight or obesity, and 2) Identification of patients with obesity risk subsidiary to weight reduction treatment, therapy goals and therapeutical strategies available to achieve them indicating as well the degree of recommendation based upon scientific evidence on each aspect. Although obesity is a disease which is supposed to involve not only medical but also political authorities, social agents, educators and food industry among others, SEEN decided to develop this Guide taking into account the evident endocrinological and metabolical aspects of this disorder. The Guide contains scientific evidencebased recommendations intended to help doctors making decisions on diagnose, evaluations and treatment of adult overweight so that a more homogeneous attendance with settled quality can be

[1]  Diane Lacaille,et al.  2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk , 2014 .

[2]  M. Lauer,et al.  Refocusing the agenda on cardiovascular guidelines: an announcement from the National Heart, Lung, and Blood Institute. , 2013, Journal of the American College of Cardiology.

[3]  M. Jessup,et al.  The next steps in developing clinical practice guidelines for prevention. , 2013, Journal of the American College of Cardiology.

[4]  Jennifer G. Robinson,et al.  Reprint: 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. , 2013, Journal of the American Pharmacists Association : JAPhA.

[5]  R. Gómez-Huelgas [Bariatric surgery versus conventional medical therapy for type 2 diabetes]. , 2012, Revista clinica espanola.

[6]  Katherine M Flegal,et al.  Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. , 2012, JAMA.

[7]  R. Abramof Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes , 2012 .

[8]  R. Ness-Abramof,et al.  A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice , 2012 .

[9]  Katherine M Flegal,et al.  Prevalence of obesity in the United States, 2009-2010. , 2012, NCHS data brief.

[10]  Thomas A Louis,et al.  Comparative effectiveness of weight-loss interventions in clinical practice. , 2011, The New England journal of medicine.

[11]  Josip Car,et al.  Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults. , 2011, The Cochrane database of systematic reviews.

[12]  Jonathan Krakoff,et al.  Four‐Year Weight Losses in the Look AHEAD Study: Factors Associated With Long‐Term Success , 2011, Obesity.

[13]  I. Kehagias,et al.  Randomized Clinical Trial of Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Management of Patients with BMI < 50 kg/m2 , 2011, Obesity surgery.

[14]  T. Wadden,et al.  Benefits of Modest Weight Loss in Improving Cardiovascular Risk Factors in Overweight and Obese Individuals With Type 2 Diabetes , 2011, Diabetes Care.

[15]  J. Danesh,et al.  Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies , 2011, The Lancet.

[16]  D. West,et al.  A Motivation-Focused Weight Loss Maintenance Program is an Effective Alternative to a Skill-Based Approach , 2010, International Journal of Obesity.

[17]  L. Sharp,et al.  Obesity Reduction Black Intervention Trial (ORBIT): 18‐Month Results , 2010, Obesity.

[18]  S. Rössner,et al.  Long‐term changes in blood pressure following orlistat and sibutramine treatment: a meta‐analysis , 2010, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[19]  C. Rock,et al.  Effect of a free prepared meal and incentivized weight loss program on weight loss and weight loss maintenance in obese and overweight women: a randomized controlled trial. , 2010, JAMA.

[20]  Rena R Wing,et al.  Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. , 2010, Archives of internal medicine.

[21]  T. Wadden,et al.  Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet , 2010, Annals of Internal Medicine.

[22]  Alan VanBiervliet,et al.  Internet delivered behavioral obesity treatment. , 2010, Preventive medicine.

[23]  D. Giugliano,et al.  Effects of a Mediterranean-Style Diet on the Need for Antihyperglycemic Drug Therapy in Patients With Newly Diagnosed Type 2 Diabetes: A Randomized Trial , 2010 .

[24]  G. Colditz,et al.  Obesity and Cancer , 2010, The oncologist.

[25]  Jutta Mata,et al.  Mediators of Weight Loss and Weight Loss Maintenance in Middle‐aged Women , 2010, Obesity.

[26]  A. Avenell,et al.  Interventions to achieve long-term weight loss in obese older people: a systematic review and meta-analysis. , 2010, Age and ageing.

[27]  F. G. Benedict,et al.  A biometric study of basal metabolism in man , 2010 .

[28]  David M Nathan,et al.  10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. , 2009, Lancet.

[29]  Matthias Lenz,et al.  The morbidity and mortality associated with overweight and obesity in adulthood: a systematic review. , 2009, Deutsches Arzteblatt international.

[30]  A. Smit,et al.  Preventing weight gain: one-year results of a randomized lifestyle intervention. , 2009, American journal of preventive medicine.

[31]  T. Wadden,et al.  A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. , 2009, Archives of internal medicine.

[32]  B. Wolfe,et al.  Perioperative safety in the longitudinal assessment of bariatric surgery. , 2009, The New England journal of medicine.

[33]  C. Bouchard,et al.  Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. , 2009, The Lancet. Oncology.

[34]  Donald A Williamson,et al.  Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. , 2009, The New England journal of medicine.

[35]  P. Schwarz,et al.  Prevention of Diabetes Self-Management Program (PREDIAS): Effects on Weight, Metabolic Risk Factors, and Behavioral Outcomes , 2009, Diabetes Care.

[36]  K. Fox,et al.  Comparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factors , 2009, Public Health Nutrition.

[37]  E. Vittinghoff,et al.  Weight loss to treat urinary incontinence in overweight and obese women. , 2009, The New England journal of medicine.

[38]  M. Tulloch-Reid,et al.  Weight loss of black, white, and Hispanic men and women in the Diabetes Prevention Program , 2009 .

[39]  T. Wadden,et al.  One‐year Weight Losses in the Look AHEAD Study: Factors Associated With Success , 2009, Obesity.

[40]  R. Collins,et al.  Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies , 2009, The Lancet.

[41]  N. Barengo,et al.  Weight loss by mobile phone: a 1-year effectiveness study , 2009, Public Health Nutrition.

[42]  K. Dale,et al.  Sustainability of lifestyle changes following an intensive lifestyle intervention in insulin resistant adults: Follow-up at 2-years. , 2009, Asia Pacific journal of clinical nutrition.

[43]  L. Sharp,et al.  Obesity Reduction Black Intervention Trial (ORBIT): Six‐month Results , 2009, Obesity.

[44]  A. Berghold,et al.  Long-term effects of weight-reducing drugs in hypertensive patients. , 2009, The Cochrane database of systematic reviews.

[45]  L. Sjöström Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study , 2008, International Journal of Obesity.

[46]  M. Limacher,et al.  Extended-care programs for weight management in rural communities: the treatment of obesity in underserved rural settings (TOURS) randomized trial. , 2008, Archives of internal medicine.

[47]  C. Greaves,et al.  Motivational interviewing for modifying diabetes risk: a randomised controlled trial. , 2008, The British journal of general practice : the journal of the Royal College of General Practitioners.

[48]  Bess H Marcus,et al.  Effect of exercise on 24-month weight loss maintenance in overweight women. , 2008, Archives of internal medicine.

[49]  R. Peterli,et al.  Predictors of outcome in treatment of morbid obesity by laparoscopic adjustable gastric banding: results of a prospective study of 380 patients. , 2008, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[50]  Scott B Going,et al.  Maintenance of Weight Loss in Overweight Middle‐aged Women Through the Internet , 2008, Obesity.

[51]  L. Gellman,et al.  Laparoscopic vs Open Gastric Bypass in the Management of Morbid Obesity: A 7-year Retrospective Study of 1,364 Patients from a Single Center , 2008, Obesity surgery.

[52]  U. Siering,et al.  Long-term Effects of Weight-Reducing Interventions in Hypertensive Patients: Systematic Review and Meta-analysis , 2009 .

[53]  Alan Bauck,et al.  Comparison of strategies for sustaining weight loss: the weight loss maintenance randomized controlled trial. , 2008, JAMA.

[54]  Christine M Hunter,et al.  Weight management using the internet a randomized controlled trial. , 2008, American journal of preventive medicine.

[55]  Beth C Bock,et al.  Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight. , 2008, Archives of internal medicine.

[56]  Margaret Anderson,et al.  Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. , 2008, JAMA.

[57]  D. Lau,et al.  overweight: updated meta-analysis Long term pharmacotherapy for obesity and , 2007 .

[58]  A. Avenell,et al.  Long‐term weight loss effects on all cause mortality in overweight/obese populations , 2007, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[59]  N. Barnard,et al.  A Two‐Year Randomized Weight Loss Trial Comparing a Vegan Diet to a More Moderate Low‐Fat Diet , 2007, Obesity.

[60]  L. Burke,et al.  Effects of a vegetarian diet and treatment preference on biochemical and dietary variables in overweight and obese adults: a randomized clinical trial. , 2007, The American journal of clinical nutrition.

[61]  Claude Bouchard,et al.  Effects of bariatric surgery on mortality in Swedish obese subjects. , 2007, The New England journal of medicine.

[62]  L. Baur,et al.  Low glycaemic index or low glycaemic load diets for overweight and obesity. , 2007, The Cochrane database of systematic reviews.

[63]  M. Bessler,et al.  Prospective randomized trial of banded versus nonbanded gastric bypass for the super obese: early results. , 2007, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[64]  Markku Peltonen,et al.  Two year reduction in sleep apnea symptoms and associated diabetes incidence after weight loss in severe obesity. , 2007, Sleep.

[65]  C. Ebbeling,et al.  Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. , 2007, JAMA.

[66]  D. Tate,et al.  Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? , 2007, The American journal of clinical nutrition.

[67]  J. DeLany,et al.  Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in CALERIE: a 1-y randomized controlled trial. , 2007, The American journal of clinical nutrition.

[68]  C. Rock,et al.  Randomized Trial of a Multifaceted Commercial Weight Loss Program , 2007, Obesity.

[69]  G. Bray,et al.  Reduction in Weight and Cardiovascular Disease Risk Factors in Individuals With Type 2 Diabetes , 2007, Diabetes Care.

[70]  M Sullivan,et al.  Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study , 2007, International Journal of Obesity.

[71]  I. Bretón Lesmes,et al.  Short-, Mid- and Long-Term Results of Larrad Biliopancreatic Diversion , 2007, Obesity surgery.

[72]  G. Enzi,et al.  Laparoscopic Adjustable Gastric Banding in 1,791 Consecutive Obese Patients: 12-Year Results , 2007, Obesity surgery.

[73]  L. Angrisani,et al.  Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial. , 2007, Surgery for Obesity and Related Diseases.

[74]  J. Lekakis,et al.  Weight loss after bariatric surgery improves aortic elastic properties and left ventricular function in individuals with morbid obesity: a 3-year follow-up study , 2007, Journal of hypertension.

[75]  J. Harvey-Berino,et al.  Weight Loss on the Web: A Pilot Study Comparing a Structured Behavioral Intervention to a Commercial Program , 2007, Obesity.

[76]  W. Richards,et al.  A comparison of 399 open and 568 laparoscopic gastric bypasses performed during a 4-year period , 2007, Surgical Endoscopy.

[77]  A. Greenberg,et al.  The Effects of the Dietary Glycemic Load on Type 2 Diabetes Risk Factors during Weight Loss , 2006, Obesity.

[78]  N. Scopinaro,et al.  Type 2 Diabetes and Weight Loss following Biliopancreatic Diversion for Obesity , 2006, Obesity surgery.

[79]  C. Del Mar,et al.  Exercise for overweight or obesity. , 2006, The Cochrane database of systematic reviews.

[80]  Deborah F Tate,et al.  A self-regulation program for maintenance of weight loss. , 2006, The New England journal of medicine.

[81]  R. Ross,et al.  Weight Loss Strategies for Obese Adults: Personalized Weight Management Program vs. Standard Care , 2006, Obesity.

[82]  Treatment of Mild to Moderate Obesity With Laparoscopic Adjustable Gastric Banding or an Intensive Medical Program: A Randomized Trial , 2006 .

[83]  M. Livingstone,et al.  Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC “diet trials” , 2006, BMJ : British Medical Journal.

[84]  T. Wadden,et al.  The Look AHEAD Study: A Description of the Lifestyle Intervention and the Evidence Supporting It , 2006, Obesity.

[85]  P. J. Larsen,et al.  [The genetics of obesity]. , 2006, Ugeskrift for laeger.

[86]  J. Douketis,et al.  Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice , 2005, International Journal of Obesity.

[87]  V. Somers,et al.  Safety and efficacy of bariatric surgery in patients with coronary artery disease. , 2005, Mayo Clinic proceedings.

[88]  M. Zemel,et al.  Effect of energy-reduced diets high in dairy products and fiber on weight loss in obese adults. , 2005, Obesity research.

[89]  A. Avenell,et al.  Effects of Weight Loss in Overweight/Obese Individuals and Long-Term Hypertension Outcomes: A Systematic Review , 2005, Hypertension.

[90]  D. Jarjoura,et al.  Transtheoretical model-chronic disease care for obesity in primary care: a randomized trial. , 2005, Obesity research.

[91]  C. Schmid,et al.  Long-term non-pharmacological weight loss interventions for adults with prediabetes. , 2005, The Cochrane database of systematic reviews.

[92]  N. Scopinaro,et al.  Effect of Biliopancreatic Diversion on Hypertension in Severely Obese Patients , 2005, Hypertension Research.

[93]  M. Westerterp-Plantenga,et al.  Additional protein intake limits weight regain after weight loss in humans , 2005, British Journal of Nutrition.

[94]  C. Schmid,et al.  Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus. , 2005, The Cochrane database of systematic reviews.

[95]  C. Schmid,et al.  Long-term non-pharmacologic weight loss interventions for adults with type 2 diabetes. , 2005, The Cochrane database of systematic reviews.

[96]  F. Horber,et al.  Management of failed adjustable gastric banding. , 2005, Surgery.

[97]  I. Naslund Lessons from the Swedish Obese Subjects Study: The effects of surgically induced weight loss on obesity comorbidity. , 2005, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[98]  Claude Bouchard,et al.  Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. , 2004, The New England journal of medicine.

[99]  S. Klein Long-term pharmacotherapy for obesity. , 2004, Obesity research.

[100]  F. Horber,et al.  Laparoscopic Gastric Bypass Is Superior to Laparoscopic Gastric Banding for Treatment of Morbid Obesity , 2004, Annals of surgery.

[101]  B. Hutton,et al.  Changes in body weight and serum lipid profile in obese patients treated with orlistat in addition to a hypocaloric diet: a systematic review of randomized clinical trials. , 2004, The American journal of clinical nutrition.

[102]  Susan L Norris,et al.  Long-term effectiveness of lifestyle and behavioral weight loss interventions in adults with type 2 diabetes: a meta-analysis. , 2004, The American journal of medicine.

[103]  W. Ambrosius,et al.  Is serum leptin related to physical function and is it modifiable through weight loss and exercise in older adults with knee osteoarthritis? , 2004, International Journal of Obesity.

[104]  S. Toubro,et al.  Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial , 2004, International Journal of Obesity.

[105]  M. Gladis,et al.  Dieting and the development of eating disorders in obese women: results of a randomized controlled trial. , 2004, The American journal of clinical nutrition.

[106]  N. Barnard,et al.  Effects of a low-fat vegan diet and a Step II diet on macro- and micronutrient intakes in overweight postmenopausal women. , 2004, Nutrition.

[107]  A. Avenell,et al.  What are the long-term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials. , 2004, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[108]  A. Avenell,et al.  What interventions should we add to weight reducing diets in adults with obesity? A systematic review of randomized controlled trials of adding drug therapy, exercise, behaviour therapy or combinations of these interventions. , 2004, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[109]  Mark R Conaway,et al.  Translating lifestyle intervention to practice in obese patients with type 2 diabetes: Improving Control with Activity and Nutrition (ICAN) study. , 2004, Diabetes care.

[110]  R. Marfella,et al.  Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. , 2004, JAMA.

[111]  T. Wadden,et al.  A randomized controlled trial of a commercial internet weight loss program. , 2004, Obesity research.

[112]  M. Sevick,et al.  Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. , 2004, Arthritis and rheumatism.

[113]  E. Bleecker,et al.  Diet-induced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial. , 2004, The American journal of clinical nutrition.

[114]  A. Avenell,et al.  Weight loss in obese diabetic and non‐diabetic individuals and long‐term diabetes outcomes – a systematic review , 2004, Diabetes, obesity & metabolism.

[115]  J. Sabate,et al.  Almonds vs complex carbohydrates in a weight reduction program , 2004, International Journal of Obesity.

[116]  Jean Harvey-Berino,et al.  Effect of internet support on the long-term maintenance of weight loss. , 2004, Obesity research.

[117]  Brian P. Mulhall,et al.  Nonalcoholic steatohepatitis , 2004, Current treatment options in gastroenterology.

[118]  K. J. Smith,et al.  Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women , 2004, Diabetologia.

[119]  M K Campbell,et al.  Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. , 2004, Health technology assessment.

[120]  D. Lau,et al.  Long-term pharmacotherapy for overweight and obesity: a systematic review and meta-analysis of randomized controlled trials , 2003, International Journal of Obesity.

[121]  Jaakko Tuomilehto,et al.  The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. , 2003, Diabetes care.

[122]  M. Schwartz,et al.  Genetics and pathophysiology of human obesity. , 2003, Annual review of medicine.

[123]  D. Lau,et al.  Long‐term pharmacotherapy for obesity and overweight , 2003 .

[124]  Deborah F Tate,et al.  Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? , 2003, The American journal of clinical nutrition.

[125]  B. Marcus,et al.  Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. , 2003, JAMA.

[126]  C. Sjöström Surgery as an intervention for obesity. Results from the Swedish obese subjects study. , 2003, Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society.

[127]  W Jack Rejeski,et al.  The Arthritis, Diet and Activity Promotion Trial (ADAPT): design, rationale, and baseline results. , 2003, Controlled clinical trials.

[128]  T. Valle,et al.  Prevention of diabetes mellitus in subjects with impaired glucose tolerance in the Finnish Diabetes Prevention Study: results from a randomized clinical trial. , 2003, Journal of the American Society of Nephrology : JASN.

[129]  F. Horber,et al.  Laparoscopic Swedish Adjustable Gastric Banding: a Five-Year Prospective Study , 2003, Obesity surgery.

[130]  T. Sane,et al.  Sex hormones and sexual function in obese men losing weight. , 2003, Obesity research.

[131]  P. Glasziou,et al.  Should we recommend low‐fat diets for obesity? , 2003, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[132]  D. Tate,et al.  Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. , 2003, JAMA.

[133]  Alessandro Pontillo,et al.  Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. , 2003, JAMA.

[134]  Stanley Heshka,et al.  Weight loss with self-help compared with a structured commercial program: a randomized trial. , 2003, JAMA.

[135]  X. Pi-Sunyer A Clinical View of the Obesity Problem , 2003, Science.

[136]  D. Allison,et al.  Years of life lost due to obesity. , 2003, JAMA.

[137]  A. Mokdad,et al.  Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. , 2003, JAMA.

[138]  D. Levy,et al.  Obesity and the risk of heart failure. , 2003, The New England journal of medicine.

[139]  K. Fujioka,et al.  Management of obesity as a chronic disease: nonpharmacologic, pharmacologic, and surgical options. , 2002, Obesity Research.

[140]  H. Schunkert Obesity and target organ damage: the heart , 2002, International Journal of Obesity.

[141]  Jacqueline A Pugh,et al.  Management of overweight and obese adults , 2002, BMJ : British Medical Journal.

[142]  E. Snyder,et al.  Melanocortin 4 receptor sequence variations are seldom a cause of human obesity: the Swedish Obese Subjects, the HERITAGE Family Study, and a Memphis cohort. , 2002, The Journal of clinical endocrinology and metabolism.

[143]  T. Key,et al.  The effect of diet on risk of cancer , 2002, The Lancet.

[144]  B. Penninx,et al.  Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. , 2002, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[145]  M. Schwartz,et al.  Obesity: Keeping hunger at bay , 2002, Nature.

[146]  C. Billington,et al.  Obesity: its time has come. , 2002, American journal of hypertension.

[147]  J. Himpens,et al.  Laparoscopic Banding: Selection and Technique in 830 Patients , 2002, Obesity surgery.

[148]  S. Toubro,et al.  Effect of protein intake on bone mineralization during weight loss: a 6-month trial. , 2002, Obesity research.

[149]  K. Kukkonen-Harjula,et al.  Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial , 2002, International Journal of Obesity.

[150]  T. Sane,et al.  Health-related quality of life in WHO Class II–III obese men losing weight with very-low-energy diet and behaviour modification: a randomised clinical trial , 2002, International Journal of Obesity.

[151]  E. Snyder,et al.  The human obesity gene map: the 2001 update. , 2002, Obesity research.

[152]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[153]  Alan C. Wilson,et al.  Ethnic comparison of weight loss in the Trial of Nonpharmacologic Interventions in the Elderly. , 2002, Obesity research.

[154]  W. Dietz,et al.  Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. , 2002, JAMA.

[155]  A. Prentice,et al.  Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. , 2002, The American journal of clinical nutrition.

[156]  J. L. Gutiérrez-Fisac,et al.  Changes in the prevalence of overweight and obesity and their risk factors in Spain, 1987-1997. , 2002, Preventive medicine.

[157]  T. Harder,et al.  Long-term impact of neonatal breast-feeding on body weight and glucose tolerance in children of diabetic mothers. , 2002, Diabetes care.

[158]  R. Wing,et al.  Successful weight loss maintenance. , 2003, Annual review of nutrition.

[159]  S. S. St. Jeor,et al.  Meal replacements in weight intervention. , 2001, Obesity research.

[160]  R. Harbour,et al.  A new system for grading recommendations in evidence based guidelines , 2001, BMJ : British Medical Journal.

[161]  M. Perri,et al.  Relapse prevention training and problem-solving therapy in the long-term management of obesity. , 2001, Journal of consulting and clinical psychology.

[162]  J. Lyznicki,et al.  Obesity: assessment and management in primary care. , 2001, American family physician.

[163]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[164]  Markku Peltonen,et al.  Blood pressure and pulse pressure during long-term weight loss in the obese: the Swedish Obese Subjects (SOS) Intervention Study. , 2001, Obesity research.

[165]  T. Vasankari,et al.  Reduced oxidized low-density lipoprotein after weight reduction in obese premenopausal women , 2001, International Journal of Obesity.

[166]  N. Milas,et al.  Long-Term Weight Loss and Changes in Blood Pressure: Results of the Trials of Hypertension Prevention, Phase II , 2001, Annals of Internal Medicine.

[167]  S. O’Meara,et al.  A rapid and systematic review of the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity. , 2001, Health technology assessment.

[168]  A. Astrup,et al.  Obesity : Preventing and managing the global epidemic , 2000 .

[169]  K. Donato,et al.  Body mass index and the prevalence of hypertension and dyslipidemia. , 2000, Obesity research.

[170]  F. Lopez,et al.  [Childhood and adolescent obesity] , 2000, Jornal de pediatria.

[171]  K. Flegal,et al.  Criteria for definition of overweight in transition: background and recommendations for the United States. , 2000, The American journal of clinical nutrition.

[172]  V. Hubbard Defining overweight and obesity: what are the issues? , 2000, The American journal of clinical nutrition.

[173]  E. Arnesen,et al.  Impact of body weight on blood pressure with a focus on sex differences: the Tromso Study, 1986-1995. , 2000, Archives of internal medicine.

[174]  M. Thun,et al.  Intentional weight loss and mortality among overweight individuals with diabetes. , 2000, Diabetes care.

[175]  F. Lindgärde The effect of orlistat on body weight and coronary heart disease risk profile in obese patients: The Swedish Multimorbidity Study , 2000, Journal of internal medicine.

[176]  F. Greenway,et al.  Self-help weight loss versus a structured commercial program after 26 weeks: a randomized controlled study. , 2000, The American journal of medicine.

[177]  J. Tuomilehto,et al.  Educational level, relative body weight, and changes in their association over 10 years: an international perspective from the WHO MONICA Project. , 2000, American journal of public health.

[178]  K. Kukkonen-Harjula,et al.  Effects of walking training on weight maintenance after a very-low-energy diet in premenopausal obese women: a randomized controlled trial. , 2000, Archives of internal medicine.

[179]  J. Hayano,et al.  Exercise and weight loss reduce blood pressure in men and women with mild hypertension: effects on cardiovascular, metabolic, and hemodynamic functioning. , 2000, Archives of internal medicine.

[180]  R. Bergström,et al.  No relation between body mass and gastro-oesophageal reflux symptoms in a Swedish population based study , 2000, Gut.

[181]  H Wedel,et al.  Differentiated long-term effects of intentional weight loss on diabetes and hypertension. , 2000, Hypertension.

[182]  S. O’Rahilly,et al.  The perils of portliness: causes and consequences of visceral adiposity. , 2000, Diabetes.

[183]  T. Valle,et al.  The Finnish Diabetes Prevention Study , 2000, British Journal of Nutrition.

[184]  Christina Wee,et al.  Screening for Cervical and Breast Cancer: Is Obesity an Unrecognized Barrier to Preventive Care? , 2000, Annals of Internal Medicine.

[185]  A. Ballinger Orlistat in the treatment of obesity , 2000, Expert opinion on pharmacotherapy.

[186]  Gregory S. Barsh,et al.  Genetics of body-weight regulation , 2000, Nature.

[187]  S. Woods,et al.  Central nervous system control of food intake , 2000, Nature.

[188]  T. Poussa,et al.  Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study , 2000, BMJ : British Medical Journal.

[189]  R. Kushner,et al.  Evaluation of the obese patient. Practical considerations. , 2000, The Medical clinics of North America.

[190]  A. Heck,et al.  Orlistat, a New Lipase Inhibitor for the Management of Obesity , 2000, Pharmacotherapy.

[191]  G. Williams,et al.  One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicentre study of orlistat, a gastrointestinal lipase inhibitor , 2000, International Journal of Obesity.

[192]  M. Thun,et al.  Body-Mass Index and Mortality in a Prospective Cohort of US Adults , 2000 .

[193]  C. Lucas,et al.  Orlistat in the long-term treatment of obesity in primary care settings. , 2000, Archives of family medicine.

[194]  Sociedad Española para el Estudio de la Obesidad Consenso SEEDO'2000 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapéutica , 2000 .

[195]  S. Toubro,et al.  Changes in renal function during weight loss induced by high vs low-protein low-fat diets in overweight subjects , 1999, International Journal of Obesity.

[196]  G. Colditz,et al.  The disease burden associated with overweight and obesity. , 1999, JAMA.

[197]  J M Jakicic,et al.  Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. , 1999, JAMA.

[198]  L. Lissner,et al.  Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. , 1999, Obesity research.

[199]  Berthold Koletzko,et al.  Breast feeding and obesity: cross sectional study , 1999, BMJ.

[200]  J. Sánchez-Payá,et al.  Obesity: a prognostic factor of severity in acute pancreatitis. , 1999, Pancreas.

[201]  A R Zinsmeister,et al.  Risk factors associated with symptoms of gastroesophageal reflux. , 1999, The American journal of medicine.

[202]  H. Wedel,et al.  Sick leave and disability pension before and after treatment for obesity: A report from the Swedish Obese Subjects (SOS) study , 1999, International Journal of Obesity.

[203]  K. Fujioka,et al.  Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-y study. , 1999, The American journal of clinical nutrition.

[204]  T. Valle,et al.  Prevention of Type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland Study design and 1-year interim report on the feasibility of the lifestyle intervention programme , 1999, Diabetologia.

[205]  R. D'Agostino,et al.  Clustering of metabolic factors and coronary heart disease. , 1999, Archives of internal medicine.

[206]  S. Toubro,et al.  Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity , 1999, International Journal of Obesity.

[207]  M. Thun,et al.  Prospective study of intentional weight loss and mortality in overweight white men aged 40-64 years. , 1999, American journal of epidemiology.

[208]  M. Perri,et al.  Effects of exercise-focused versus weight-focused maintenance programs on the management of obesity. , 1999, Addictive behaviors.

[209]  S. Blair,et al.  Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. , 1999, The American journal of clinical nutrition.

[210]  John Attia,et al.  Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity , 1999 .

[211]  L. Sjöström,et al.  Effects on body weight of strict or liberal adherence to an initial period of VLCD treatment. A randomised, one-year clinical trial of obese subjects , 1999, International Journal of Obesity.

[212]  T. Wadden,et al.  Effects of lifestyle activity vs structured aerobic exercise in obese women: a randomized trial. , 1999, JAMA.

[213]  S. Heymsfield,et al.  Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. , 1999, JAMA.

[214]  Y. Chagnon,et al.  The human obesity gene map: the 1998 update. , 1999, Obesity research.

[215]  G. Bray,et al.  Dietary fat intake does affect obesity! , 1998, The American journal of clinical nutrition.

[216]  P. Deurenberg,et al.  Body mass index and percent body fat: a meta analysis among different ethnic groups , 1998, International Journal of Obesity.

[217]  Roy A Kaplan,et al.  Role of Orlistat in the Treatment of Obese Patients With Type 2 Diabetes: A 1-year randomized double-blind study , 1998, Diabetes Care.

[218]  Alain Golay,et al.  Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients , 1998, The Lancet.

[219]  W L Haskell,et al.  Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. , 1998, The New England journal of medicine.

[220]  Ronald M. Krauss,et al.  American Heart Association Call to Action: Obesity as a Major Risk Factor for Coronary Heart Disease , 1998 .

[221]  L. V. Van Gaal,et al.  Efficacy and tolerability of orlistat in the treatment of obesity: a 6-month dose-ranging study , 1998, European Journal of Clinical Pharmacology.

[222]  P. Whelton,et al.  Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. , 1998, JAMA.

[223]  A. Scheen,et al.  Liver abnormalities in severely obese subjects: Effect of drastic weight loss after gastroplasty , 1998, International Journal of Obesity.

[224]  M. Sullivan,et al.  Swedish obese subjects (SOS) – an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity , 1998, International Journal of Obesity.

[225]  M. Slattery,et al.  Body size and the risk of colon cancer in a large case-control study , 1998, International Journal of Obesity.

[226]  F. Speizer,et al.  Body Weight, Weight Change, and Risk for Hypertension in Women , 1998, Annals of Internal Medicine.

[227]  Treatment of Obesity in Adults Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. , 1998, Obesity research.

[228]  L. Alexander Guidelines for hypertension treatment: applications for primary care practice--a review of the JNC VI report. , 1998, Lippincott's primary care practice.

[229]  G A Colditz,et al.  Dual effects of weight and weight gain on breast cancer risk. , 1997, JAMA.

[230]  O. Shoheiber,et al.  Estimation of the cost savings resulting from the use of ursodiol for the prevention of gallstones in obese patients undergoing rapid weight reduction , 1997, International Journal of Obesity.

[231]  Ralph B D'Agostino,et al.  Risk Variable Clustering in the Insulin Resistance Syndrome: The Framingham Offspring Study , 1997, Diabetes.

[232]  J. Manson,et al.  A prospective study of body mass index, weight change, and risk of stroke in women. , 1997, JAMA.

[233]  L. Marinis,et al.  Impact of long-term naltrexone treatment on growth hormone and insulin secretion in hyperandrogenic and normal obese patients. , 1997, Metabolism: clinical and experimental.

[234]  G. Bray Progress in understanding the genetics of obesity. , 1997, The Journal of nutrition.

[235]  L. V. Van Gaal,et al.  The beneficial effects of modest weight loss on cardiovascular risk factors. , 1997, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[236]  T. Sheldon,et al.  The treatment and prevention of obesity: a systematic review of the literature. , 1997, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[237]  T. Spector,et al.  The association of obesity with osteoarthritis of the hand and knee in women: a twin study. , 1996, The Journal of rheumatology.

[238]  J Pekkanen,et al.  Body weight, cardiovascular risk factors, and coronary mortality. 15-year follow-up of middle-aged men and women in eastern Finland. , 1996, Circulation.

[239]  F. Casanueva,et al.  Impaired growth hormone secretion in obese subjects is partially reversed by acipimox-mediated plasma free fatty acid depression. , 1996, The Journal of clinical endocrinology and metabolism.

[240]  K. Flegal,et al.  The influence of smoking cessation on the prevalence of overweight in the United States. , 1995, The New England journal of medicine.

[241]  M. Fernstrom Drugs that cause weight gain. , 1995, Obesity research.

[242]  G. Blackburn,et al.  Effect of degree of weight loss on health benefits. , 1995, Obesity research.

[243]  M. Thun,et al.  Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40-64 years. , 1995, American journal of epidemiology.

[244]  L. Sjöström,et al.  Orlistat (Ro 18-0647), a lipase inhibitor, in the treatment of human obesity: a multiple dose study. , 1995, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[245]  R. Leibel,et al.  Changes in energy expenditure resulting from altered body weight. , 1995, The New England journal of medicine.

[246]  J. Schenker,et al.  Effects of low-dose estrogen oral contraceptives on weight, body composition, and fat distribution in young women. , 1995, Fertility and sterility.

[247]  M. Muggeo,et al.  Hyperuricaemia: relationships to body fat distribution and other components of the insulin resistance syndrome in 38-year-old healthy men and women. , 1995, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[248]  C. Tse,et al.  Assessing Impact of Weight on Quality of Life. , 1995, Obesity research.

[249]  D. Bild,et al.  Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study. , 1994, JAMA.

[250]  P. Blackman Actual causes of death in the United States. , 1994, JAMA.

[251]  A Tremblay,et al.  Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. , 1994, The American journal of cardiology.

[252]  T. Wadden,et al.  Treatment of Obesity by Moderate and Severe Caloric Restriction: Results of Clinical Research Trials , 1993, Annals of Internal Medicine.

[253]  W H Dietz,et al.  Social and economic consequences of overweight in adolescence and young adulthood. , 1993, The New England journal of medicine.

[254]  D. Kirschenbaum,et al.  Obese people who seek treatment have different characteristics than those who do not seek treatment. , 1993, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[255]  R. Pasquali,et al.  The impact of obesity on hyperandrogenism and polycystic ovary syndrome in premenopausal women * , 1993, Clinical endocrinology.

[256]  T. Spector,et al.  The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chingford Study. , 1993, The Journal of rheumatology.

[257]  F. Pi‐Sunyer,et al.  Medical Hazards of Obesity , 1993, Annals of Internal Medicine.

[258]  A. Dattilo,et al.  Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. , 1992, The American journal of clinical nutrition.

[259]  B. Goldstein,et al.  Beneficial health effects of modest weight loss. , 1992, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[260]  J. Manson,et al.  Risk of symptomatic gallstones in women with severe obesity. , 1992, The American journal of clinical nutrition.

[261]  G A Colditz,et al.  Economic costs of obesity. , 1992, The American journal of clinical nutrition.

[262]  H. Sugerman,et al.  Long-term effects of gastric surgery for treating respiratory insufficiency of obesity. , 1992, The American journal of clinical nutrition.

[263]  F. Schaffner,et al.  Effect of weight reduction on hepatic abnormalities in overweight patients. , 1990, Gastroenterology.

[264]  M. Carey,et al.  Pathophysiology and Pathogenesis of Cholesterol Gallstone Formation , 1990, Seminars in liver disease.

[265]  G. Mcclearn,et al.  The body-mass index of twins who have been reared apart. , 1990, The New England journal of medicine.

[266]  B Rosner,et al.  A prospective study of obesity and risk of coronary heart disease in women. , 1990, The New England journal of medicine.

[267]  M. Mifflin,et al.  A new predictive equation for resting energy expenditure in healthy individuals. , 1990, The American journal of clinical nutrition.

[268]  H. Mossberg 40-YEAR FOLLOW-UP OF OVERWEIGHT CHILDREN , 1989, The Lancet.

[269]  W L Haskell,et al.  Regional adiposity patterns in relation to lipids, lipoprotein cholesterol, and lipoprotein subfraction mass in men. , 1989, The Journal of clinical endocrinology and metabolism.

[270]  J. Rodin,et al.  Psychological features of obesity. , 1989, The Medical clinics of North America.

[271]  G. Bonorris,et al.  Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight. , 1988, The New England journal of medicine.

[272]  G. Reaven Role of Insulin Resistance in Human Disease , 1988, Diabetes.

[273]  R R Wing,et al.  Long-term effects of modest weight loss in type II diabetic patients. , 1987, Archives of internal medicine.

[274]  B. Rodgers,et al.  Onset of obesity in a 36 year birth cohort study. , 1986, British medical journal.

[275]  A. Stunkard,et al.  An adoption study of human obesity. , 1986, The New England journal of medicine.

[276]  P. Björntorp,et al.  The Influence of Body Fat Distribution on the Incidence of Diabetes Mellitus: 13.5 Years of Follow-up of the Participants in the Study of Men Born in 1913 , 1985, Diabetes.

[277]  D. Sackett,et al.  Failure of weight reduction to reduce mildly elevated blood pressure: a randomized trial. , 1984, Journal of hypertension.

[278]  F. Schaffner,et al.  Fatty liver hepatitis and cirrhosis in obese patients. , 1979, The American journal of medicine.

[279]  S. Heyden The workinghman's diet. II. Effect of weight reduction in obese patients with hypertension, diabetes, hyperuricemia and hyperlipidemia. , 1978, Nutrition and metabolism.

[280]  M. Zara [Drug therapy of obesity]. , 1970, Therapeutique.

[281]  M. Scherrer,et al.  [Obesity and pulmonary function]. , 1970, Schweizerische medizinische Wochenschrift.

[282]  W. Kannel,et al.  The relation of adiposity to blood pressure and development of hypertension. The Framingham study. , 1967, Annals of internal medicine.

[283]  D. A. Seaton,et al.  The Treatment of Obesity , 1963, The British journal of clinical practice.

[284]  C. F. Gastineau,et al.  The evaluation of the obese patient. , 1962, Geriatrics.

[285]  J. Vague,et al.  The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. , 1956, The American journal of clinical nutrition.