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Food is one of the greatest pleasures of life. For many, more especially in the developed world, overindulgence and a less active lifestyle have generated the so-called epidemic of obesity. Despite this, many societies place great emphasis on a perfect, slim body shape and may discriminate against those who are overweight. There are strong individual differences in body weight, and hardly a month goes by without the announcement of yet another gene 'for' obesity, with discussion of the implications of those who hope to reduce their body weight, How should individuals and governments respond to the different challenges of obesity?
The book takes a multidisciplinary approach, beginning with a broad overview of issues, then moving to an examination of the biological and psychological aspects of eating behavior and exercise, and their implications for overall energy balance. These early chapters include a description of human nutrition and physiology, particularly in relation to adipose tissue, and an examination of the way in which the brain receives information from the rest of the body about likely energy needs. One of the most important questions about obesity is why some individuals are so much heavier than others. Here, the books looks at thte contributions from genetics, development, and influences from the social environment - and the complex way in which these may interact.
Obesity increases the risk of ill health. Later chapters examine the dieases that are associated with obesity, the discrimination experienced and its effects on socio-economic status and psychological wellbeing. Obesity is often associated with recurrent efforts to lose weight. We discuss the different strategies that individuals may use to lose weight, from diet and exercise though to more medically oriented options including surgery and drug treatment. None of these methods has a good record of success and may also incur harmful side effects; these problems are addressed, together with the research that might overcome them. The book concludes by examining how governments, and others, might develop policies that respond to the challenge of overcoming the obesity epidemic.
1. A GLOBAL CHALLENGE
What is obesity?
The relationships between obesity and ill health
The economic cost of obesity
Who is most likely to become obese?
Why have so many people become overweight and obese?
Summary of Chapter 1
2. ENERGY: INTAKE AND NEEDS
What is a balanced diet?
The chemical nature of macronutrients
Measuring energy intake
Releasing energy from food
Summary of Chapter 2
3. FOOD: DIGESTION AND ABSORPTION
The digestive system
The fate of food as it passes along the gut
Absorption and distribution of fuel molecules
Summary of Chapter 3
4. METABOLISM: THE BODY'S INTERNAL BALANCING ACT
Metabolism, homeostasis and a healthy balance
Insulin and the regulation of blood glucose levels
Creating an energy reserve: longer-term storage and use of lipids
Roles of adipose tissue
Summary of Chapter 4
5. BRAIN AND BEHAVIOUR
The 'eating' brain: a quick introduction
Brain mechanisms and feeding behaviour
Summary of Chapter 5
6. INDIVIDUAL DIFFERENCES: GENES AND ENVIRONMENT
Genes and obesity
Environment and obesity
Gene-environment interactions and obesity
Factors affecting childhood obesity
Summary of Chapter 6
7. THE CONSEQUENCES OF OBESITY
The medical consequences of obesity
Psychosocial consequences of obesity
Summary of Chapter 7
8. TREATING OBESITY: DIET, EXERCISE AND LIFESTYLE
Energy balance revisited
Reducing energy intake: 'going on a diet'
Exercise as a treatment strategy for obesity
Combining exercise and diet
Lifestyle and body weight
Summary of Chapter 8
9. TREATING OBESITY: DRUGS AND SURGERY
Drug treatments for obesity
Surgical treatment of obesity
Summary of Chapter 9
10. CHALLENGING OBESITY: THE FUTURE
The obesogenic environment
Obesity and government
Evaluating policies to reduce the incidence of obesity
Combating obesity: what policies would be effective?
Summary of Chapter 10
ANSWERS AND COMMENTS
REFERENCES AND FURTHER READING