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Obesity: knowledge, care, and commitment, but not yet cure

2009; Editora da Universidade de São Paulo; Volume: 53; Issue: 2 Linguagem: Inglês

10.1590/s0004-27302009000200001

1677-9487

Bruno Geloneze, Márcio C. Mancini, Walmir Coutinho,

Obesity, Physical Activity, Diet

The devil has put a penalty on all things we enjoy in life.Either we suffer in health or we suffer in soul or we get fat."Albert Einstein "I'm fat, but I'm thin inside... there's a thin man inside every fat man." George OrwellT he management of obesity is a major public health and economic global concern.Few diseases or conditions are as common or have the health implications of obesity.Although obesity can be simply defined as a disorder of excess body fat, the major pathobiology occurs in other tissues such as hepatic, vascular system, musculoskeletal, etc (1).Obesity is undoubtedly an important risk factor for serious diseases such as cardiovascular diseases, type 2 diabetes and certain types of cancer (2).Additionally, the percentage of the world population affected by obesity is increasing at an alarming rate.Worldwide, an estimated 1.6 billion adults (aged 15 years and older) were overweight (BMI: 25-30 kg/m 2 ), and 400 million were obese (BMI > 30) in 2005.By 2015, it is expected there will be 2.3 billion overweight and more than 700 million obese adults worldwide (3).Given the financial burden and the essential clinical infrastructure needed to treat this high-risk population, major resources will be required to provide adequate care (4).Furthermore, the globalization of obesity-related diabetes requires that healthcare providers are kept up-to-date with the latest advances in obesity management strategies.This supplement contains a series of state-of-the-art reviews and some original research articles in the field of obesity and related conditions.The overall knowledge of this content provides a concise, to-the-point, theoretical and pragmatic approach, which will make possible to provide optimal care for obese patients, reinforcing our commitment and hope of finding a, not yet available, cure for obesity.Environmental factors, such as social networks and global "westernization" with respect to dietary preferences and sedentary lifestyle have a strong influence on obesity pandemics.There is a new player on this scenario.The gut microbial flora (microbiota) plays a role in converting nutrients into calories.Glycans, such as plant polysaccharides, cannot be digested with human enzymes, so bacterial enzymes are needed.The gut microbiota differs in obese and non-obese people.Weight gain in the human population grossly follows the level of antibiotic usage possibly modifying our gut microbiota.Probiotics can be defined as living organisms (Lactobacillus, for example) which beneficially affect the host by improving its intestinal microbial balance.Probiotics are increasingly used in human food.Yogurts and other fermented foods now commonly contain Lactobacillus and Bifidobacterium.Probiotics are used as adjuvant in many treatments for conditions ranging from diarrhea to the prevention of intestinal diseases (5).Their role in long-term weight gain must be evaluated.