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Clinical Practice
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Volume 358:1941-1950 May 1, 2008 Number 18
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Nonsurgical Management of Obesity in Adults
Robert H. Eckel, M.D.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 44-year-old woman desires weight reduction. Her history is notable for hypertension, snoring, daytime somnolence, and osteoarthritis. Her father was obese and had type 2 diabetes. On physical examination, her weight is 215 lb (98 kg), her body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) 32.7, her waist circumference 40 in. (102 cm), and . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Evaluation

Lifestyle Approaches

            Diet

            Low-Fat Diets

            Low-Carbohydrate Diets

            Low-Glycemic-Index Diets

            High-Protein Diets

            Specific Commercial Diets

            Physical Activity

            Behavioral Modification

Pharmacologic Therapy

Maintenance of Weight Reduction

Areas of Uncertainty

Guidelines from Professional Societies

Conclusions and Recommendations


Source Information

From the Division of Endocrinology, Metabolism, and Diabetes and the Division of Cardiology, University of Colorado Denver, Aurora.

An audio version of this article is available at www.nejm.org.

Address reprint requests to Dr. Eckel at the University of Colorado at Denver, Anschutz Medical Campus, Division of Endocrinology, Metabolism, and Diabetes, MS 8106, RC1 South, Rm. 7107, 12801 E. 17th Place, P.O. Box 6511, Aurora, CO 80045, or at robert.eckel@uchsc.edu.


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