Family Physician, 2001;11:13-16.

Abstract

Overweight and obese adults are at increased risk of both mortality and morbidity, principally from cardiovascular disease and diabetes mellitus. Intentional weight loss of 5-1 0% is associated with substantial benefits. Weight reduction should be encouraged by dietary and behavioural modification initially, with realistic targets set over an initial 6-month period. It must be emphasised that these measures should continue indefinitely. This can be complemented by pharmacological intervention with orlistat, or perhaps sibutramine when available in the near future. Given the important impact environmental and social factors have on the aetiology of obesity, the community at large should effect programmes to encourage healthy lifestyles among the populace. Town and city planners should include readily available recreational and sporting facilities in residential districts, especially in the urban and sub-urban areas. Physical education sessions in schools in both primary and secondary levels should receive more emphasis to encourage the young to make sports and physical exercise a part of life, rather than being seen as a non examinable appendage of the school curriculum. The key to defeating obesity is prevention, and an effort to lose weight once it accumulates, can often be too little, too late.