Obesity Treatment

Treatment outcome has certainly improved since Stunkard and McLaren-Hume (1959) reviewed the literature and found that less than 25% of obese patients lost 20 pounds or more and less than 5% lost 40 pounds or more. However, one of the few points on which almost all obesity researchers agree is that to date, our results are quite modest and we are generally unsuccessful in promoting effective weight maintenance among obese persons. As the title of a more recent article, "Improving long-term weight loss: Pushing the limits of treatment," (Brownell & Jeffrey, 1987, [emphasis added]) suggests, many believe that we have pushed our current treatment paradigms to the limit. It was with this background in mind that we organized the meeting from which these proceedings issue. The purpose of the three day international meeting was to evaluate the current knowledge base and conceptual paradigms of obesity treatment and to suggest directions for future research and clinical practice. Rather than simply for research reporting, the meeting was primarily for research generation. All speakers were established scientists in the field who were asked to summarize our state of knowledge in a given area rather than present the results of their latest research. Great efforts were taken to ensure that panel discussions occupied a central portion of the conference, and that the questions "What else do we need to know?" and "How do we find it out?" were consistently addressed.

In Search of Optimal Weights for U.S. Men and Women.- What Is the Weight Required for Substantial Health Gains?.- Defining Socially and Psychologically Desirable Body Weights and the Psychological Consequences of Weight Loss and Regain.- Reasonable Weights: Determinants, Definitions and Directions.- Is Weight Stability Itself a Reasonable Goal?.- Regression Change Models with Incomplete Repeated Measures Data in Obesity Research.- Are There People Who Do Not Need to Lose Weight: The Role of Body Fat Distribution and Implications from Diabetes Research.- The Effect of Central Fat Distribution on Cardiovascular Disease.- Is Self-Acceptance a Reasonable Goal?.- Cultural Factors in Desirable Body Shapes and Their Impact on Weight Loss and Maintenance.- Why Should Patients Be Matched to Treatments, How May It Occur, and How Can It Be Studied?.- Treatment Options and the Maintenance of Weight Loss.- Why Do People Fail to Maintain Weight Loss?.- What Characterizes Successful Weight Maintainers?.- Application of Behavioral Economic Principles to Treatment of Childhood Obesity.- Psychosocial Predictors of Obesity: Implications for Prevention.- The Role of Exercise in Weight Maintenance.- Diet, Palatability, and Dietary Implications of Long-Term Weight Maintenance.- Influence of the Diet's Macronutrient Composition on Weight Maintenance.- What Are Our Therapeutic Options?.- Potential Side Costs and Side Benefits of Pharmacological Treatment of Obesity.- Drug Treatment of Obesity: The Argument in Favor.- Predicting Treatment Outcome, Genetics, Neuroendocrinology, and Methodological Issues.- Behavioral and Psychological Predictors of Treatment Outcome in Obesity.- Predicting Treatment Outcome: Why We Have Been So Unsuccessful.- Prediction in Weight Management Outcome:Implications for Practice.- Neuroendocrine Aspects of Human Obesity and Fat Distribution: Potential for Intervention.- Social Stress Effects on Regional Fat Distribution in Male and Female Monkeys.- The Search for Obesity Genes.- Defining the Genetic Basis of Obesity: Challenges and Opportunities.- Research Design and Methods to Study the Genetic Epidemiology of Obesity.- Modeling and Data Analysis for Longitudinal Dietary Intervention.- Multilevel Analysis in Obesity Research.- Contributors.