Medical management of obesity.

Obesity is a heterogeneous condition. Some individuals suffer severe, life-threatening medical complications as a result of their obesity, whereas others appear to remain healthy for their entire lives despite substantially greater-than-normal amounts of body fat. A personal or family history of adverse health consequences of obesity and an upper-body fat distribution suggests that the patient will have greater health risks from obesity, and these patients stand to benefit more from successful treatment. Therefore, one can justify more aggressive approaches in helping them to make permanent changes in eating and exercise behavior, which are the cornerstones of obesity management. Supplementing these interventions with behavior therapy is necessary for patients unable to make lifestyle changes by themselves. Pharmacotherapy is appropriate for patients with medically complicated obesity in whom other approaches have not succeeded.