syndemics are characterized by biological and social interactions between conditions and states, interactions that increase a person’s susceptibility to harm or worsen their health outcomes. The Lancet Commission on Obesity proposed that obesity, undernutrition, and climate change constitute a syndemic. Malnutrition in all its forms, including obesity, undernutrition, and other dietary risks, is the leading cause of poor health globally. Climate change is a fundamental part of this because of its sweeping effects on the health of humans and the natural systems that we depend on and underpins the way that we live.
In this edition of Clinical Obesity, we focus on the textbook’s original objectives with chapters on the causes of obesity, obesity as a disease, the management of adult obesity, and childhood obesity. We also include a section on policy approaches that underline the importance of effective and sustainable policies free from political and commercial interference.
We, the editors, have spent long careers concerned about obesity, and we share an exasperation that so little has been accomplished worldwide in reversing its spiraling prevalence and its detrimental effects across all ages. Certainly, the understanding of the science and medical consequences of obesity has grown exponentially, but the drivers of excessive weight gain remain obvious in all societies, yet meaningful policy recommendations fail to be developed or translated into practice, and the economic burden from obesity grows.
We hope that this latest edition of Clinical Obesity enables its readers to understand the complexity of obesity better, both within society and the clinical setting, and provides inspiration and knowledge for those tasked with managing and tackling the condition.
We are most grateful to our co-editors for this edition, Sarah Armstrong, Arianne Sweeting, and John Wilding, for their considerable help and support in bringing this new edition to fruition. We hope that the experience will encourage them to take over the “baton” for future editions of Clinical Obesity.
Peter G. Kopelman, Ian D. Caterson, and William H. DietzLondon, Sydney, and Washington, DC
Dedication
Peter G. Kopelman
Peter was an editor for each of the four editions of Clinical Obesity in Adults and Children and lead editor for three. He died just before this edition was completed, but he asked us to ensure it was finished.
Peter was a clinician, a researcher, a teacher, and an academic leader. His research was initially into the genetics of obesity, but this developed into a wider interest in many aspects of obesity, particularly its management. He led the production of clinical guidelines, and his focus was always on the patient with obesity, and with equity. He was a leader in medical education and was executive dean of the Faculty of Health at The University of East Anglia, and then returned as principal at St George's Hospital in London, where he had trained. He became an academic leader within the Royal College of Physicians and the University of London. He was one who cared for others and strove to provide the best care for his patients, and mentoring and leadership for his students and colleagues.
For the two of us, Peter was a wonderful colleague and friend who organised and led us through the production of the last three editions of this textbook. He was a clear thinker, considerate, and helpful to us all.
This textbook, Clinical Obesity in Adults and Children, 4th Edition, is dedicated to him.
Ian D. Caterson
William H. Dietz
List of Abbreviations
| ACTH | adrenocorticotropic hormone |
| ADP | air displacement plethysmography |
| AHI | Apnea/Hypopnea Index |
| AHO | Albright hereditary osteodystrophy |
| AHS | ad hoc stomach |
| ART | assisted reproductive technology |
| ASCVD | atherosclerotic cardiovascular disease |
| ASP | acylation‐stimulating protein |
| ATP | adenosine triphosphate |
| AgRP | agouti‐related peptide |
| BAT | brown adipose tissue |
| BDI | Beck Depression Inventory |
| BED | binge‐eating disorder |
| BGL | blood glucose levels |
| BIA | bio‐electrical impedance analysis |
| BIH | benign intracranial hypertension |
| BMI | Body Mass Index |
| BMR | basal metabolic rate |
| BPD | biliopancreatic diversion procedure |
| CART | cocaine and amphetamine‐related transcript |
| CBT | cognitive behavioral therapy |
| CKK | cholecystokinin |
| CETP | cholesteryl ester transfer protein |
| CHD | coronary heart disease |
| CHF | congestive heart failure |
| CI | confidence interval |
| CNS | central nervous system |
| COH | controlled ovarian hyperstimulation |
| COPD | chronic obstructive pulmonary disease |
| CPAP | continuous positive airway pressure |
| CPE | carboxypeptidase E |
| CPT1 | carnitine palmitoyl transferase‐1 |
| CRH | corticotrophin‐releasing hormone |
| CRP | C‐reactive protein |
| CT |
computed tomography
|