Medical Science Books Medical Book Review

 Professionals that are called upon to address the complex issues that constitute the prevention and management of obesity are in need of a resource that can not only succinctly outline the major associated topics, but also lead the reader toward a more effective treatment plan.  At this time the consensus is that diet and exercise alone are not the ideal treatment strategies but only part of a more global perspective which also takes into consideration the psychological and societal constructs that influence individual behavior, and the genetic and metabolic factors that may predispose one to develop overweight or obesity.  Nutritionists and exercise physiologists on the front lines of the fight against the obesity epidemic are well versed in the nutritional and activity requirements that are necessary to effect change in obese individuals, yet are most often frustrated by disappointing results in their clients.  Any resource that will be referred to by these professionals therefore must communicate recent research in all areas that are complimentary to the more traditional nutrition and activity approach.  Obesity: Etiology, Assessment, Treatment, and Prevention has as its stated purpose in the preface by the editor to be a comprehensive resource covering all related areas in the treatment of obesity.  This purpose is achieved in a surprisingly comprehensive volume for its length with major emphasis being placed on introducing the reader to, as the title suggests, all aspects of obesity management rather than extended discussions of any one area.

     The organization of the text is developed in sections devoted to the themes of the title.  Section I dealing with the etiology of obesity offers many unique perspectives on the growing epidemic by not only describing the problem statistically on a population level but also in terms of psychological roots and cultural influences which may contribute to its development.  Included in the psychological correlate chapter is some very interesting new research that actually begins to illustrate how obesity promoting behaviors such as excess caloric intake and physical inactivity many be initiated in response to the social pressures and stigma associated with being overweight, along with some sobering findings that show that even the health care workers treating overweight and obese patients may be part of the problem in terms of their attitudes and beliefs regarding etiology. 

     Section II deals with the assessment issues that must be dealt with in working with obese individuals.  Special emphasis in this section is placed on critically examining the modalities by which information regarding the status of an obese patient is gained.  For example, when discussing the measurement of physical activity and energy expenditure, time is spent on taking a closer look at what exactly each method is measuring along with the possible measurement bias that may be present in the obese population.  Research in this area is highly dependent on the ability to measure and estimate energy expenditure as well as nutritional intake in order to make sound recommendations.  Also of note in this section is a unique look at the physical examination of obese patients along with modifications which must be made in order to conduct a thorough checkup.  Given the long list of accompanying medical conditions such as dyslipidemia, and type II diabetes, this is truly important information for professionals in the primary care setting or those who work in a preventative capacity.

     Treatment and Prevention strategies are the subject of section III which in many ways resembles a more traditional text on obesity with different strategies outlined in individual chapters.  Interesting distinctions are used even in this section however as a chapter is devoted to physical activity as a treatment option for obesity, with a separate chapter devoted to decreasing sedentary behaviors largely through psychological intervention.  This dichotomy that is set up in section III speaks to the purpose of the entire text.  Exercise and nutrition alone will not adequately treat most cases of overweight and obesity, the professional must also be very aware of the psychological component.  Medication is also a warranted treatment approach for many individuals, especially those with no major comorbidities, and some of the major clinical trials that have been completed recently are discussed in a chapter on medical intervention.

     The text is full of practical information on the spectrum of research that we currently have on obesity.  Recent research is included in each chapter as the main development of chapter paragraphs are largely descriptions of studies that sometimes have some conflicting results.  There is no attempt to glaze over controversies in the field, but there is an attempt to show the interrelatedness of the various aspects of genetic, physical, nutritional, psychological, etc… factors that describe the obese individual.  This attempt is successful because of the attention to topics that are not usually included in texts on obesity such as psychological and social factors which help determine the behaviors whether unhealthy or healthy that the individual will engage in such as dietary habits and physical activity.  Those interested in a very detailed treatment of each area of research in obesity may be disappointed but few books can tie those areas together as concisely as this one.

 
     Professionals who work with obese individuals in all capacities will find something of value in this text.  Those with both population based interests and those who may work one on one with individuals will gain a better perspective of the field.  The attention to validity of measurement methods in assessing obese individuals and the reliance of research discussion throughout the text will make this book an important aid to students in the allied health sciences who are interested in pursuing obesity research.  The book is a great first resource on obesity and springboard to more in-depth coverage. 
        

Ratings (1-4 , 4 being the highest):

Organization of information: 3.5  

Usefulness of book:  3   

Suitable for intended audience:  3

Author’s objectives met:      3.5

Significant number of illustrations/Figures:     3

Quality of illustrations/Figures:    3

Table of Contents:

Part I:  Etiology of Obesity

Chapter 1.     Prevalence of Overweight and Obesity in the United States

Chapter 2.     Psychosocial Correlates and Consequences of Obesity

Chapter 3.     Economic Aspects of Obesity:  A Managed Care Perspective

Chapter 4.     Genetic Influences on Obesity

Part II:  Assessment of the Obese Patient

Chapter 5.     Health-Related Quality of Life in Obese Individuals

Chapter 6.     Body Composition Assessment in the Obese

Chapter 7.     Clinical Evaluation of the Obese Patient

Chapter 8.     Dietary Intake:  Recording and Analyzing

Chapter 9.     Assessment of Physical Activity and Energy Expenditure

Part III:  Treatment and Prevention

Chapter 10.   The Importance of Body Weight Maintenance in Successful Aging

Chapter 11.   Treating and Preventing Pediatric Obesity

Chapter 12.   Medical Nutrition Therapy Application

Chapter 13.   Physical Activity Treatment

Chapter 14.   Physical Activity As a Therapeutic Modality

Chapter 15.   Helping Individuals Reduce Sedentary Behavior

Chapter 16.   Physical Activity Promotion As a Public Health Strategy for Obesity Prevention

Chapter 17.   Medication for Weight Management

Chapter 18.   Future Directions in Treating Obesity