Obesity - an epidemic of the twenty-first century: an update for psychiatrists.

Obesity is a chronic relapsing condition associated with significant morbidity and premature mortality. The prevalence of obesity has increased dramatically over the last 20 years and continues to do so, primarily as a result of changes in dietary intake and exercise patterns. There are considerable challenges associated with the management of the obesity epidemic involving both public health policies and individual treatment. Management of the obese individual involves lifelong lifestyle change for all, drugs for some, and surgery for a few. Appropriate selection of patients and the setting of realistic goals are crucial to the success of any weight-reducing programme. The aim of obesity management is to reduce associated morbidity and mortality, not necessarily to restore normal body weight. While the current trends in obesity are depressing, a better understanding of the pathophysiology and treatment of the condition should allow the clinician to be more optimistic for the future.