The evaluation and treatment of the overweight patient

Obesity represents one of the most important treatable causes of mortality and morbidity facing the primary care physician. Approximately one of every three U.S. adults is overweight or obese, leading to more than 300,000 preventable deaths each year. Because it is a multifactorial disorder involving food intake, physical activity, metabolism, and genetic factors, obesity is best treated with a coordinated approach. Diet and exercise remain the best initial treatment focus. Orlistat and sibutramine are recently developed medications reserved for obese patients who fail conservative therapy. Surgical remedies are indicated in limited circumstances for morbidly obese individuals. As primary care physicians, obstetrician/gynecologists are ideally positioned to motivate, evaluate, and treat overweight patients. (C) 2000 Elsevier Science Inc.