Obesity and its health risks

Obesity continues to increase in prevalence, now affecting more than one third of the adult population of the United States. The health risks of obesity are proportional to increase in body mass index (weight in kilograms divided by the square of the height in meters), and include adult-onset diabetes, hypertension, hyperlipidemia and coronary artery disease, respiratory failure, and increased cancer risk. The recognized gastrointestinal complications reviewed in this article include increased risks of gallstones (especially during weight reduction); pancreatitis related to gallstones or hyperlipidemia with worse clinical outcome; nonalcoholic steatohepatitis; and increased risks of adenocarcinoma of the esophagus, colorectal adenoma, and cancer. New studies continue to define abnormalities in the genetic regulation of appetite and energy metabolism in experimental animals and human obesity. Treatment options continue to evolve, with improved pharmacologic approaches to appetite and strong support for gastric bypass surgery as the most effective treatment of severely obese patients.