Handbook of obesity

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CIinica I Ap plications
Second Edition
edited by


Pennington Biomedical Research Center Louisiana State University Baton Rouge, Louisiana, U.S.A.






The first edition of this book and its companion volume, Handbook of Obesity: Etiology and Pathophysiology, SecondEdition, was published as Handbook of Obesity, edited by George A. Bray, Claude Bouchard, and W. P. T. James (Marcel Dekker, Inc., 1998). Although great care has been taken to provide accurate and current information, neither the author(s) nor the publisher, nor anyone else associated with this publication, shall be liable for any loss, damage, or liability directly or indirectly caused or alleged to becaused by this book. The material contained herein is not intended to provide specific advice or recommendations for any specific situation. Trademark notice: Product or corporate names may be trademarks or registered trademarks and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data A catalog record for this book isavailable from the Library of Congress. ISBN: 0-8247-4773-9 This book is printed on acid-free paper. Headquarters Marcel Dekker, Inc. 270 Madison Avenue, New York, NY 10016, U.S.A. tel: 212-696-9000; fax: 212-685-4540 Distribution and Customer Service Marcel Dekker, Inc. Cimarron Road, Monticello, New York 12701, U.S.A. tel: 800-228-1160; fax: 845-796-1772 Eastern Hemisphere Distribution Marcel Dekker AGHutgasse 4, Postfach 812, CH-4001 Basel, Switzerland tel: 41-61-260-6300; fax: 41-61-260-6333 World Wide Web http://www.dekker.com The publisher offers discounts on this book when ordered in bulk quantities. For more information, write to Special Sales/ Professional Marketing at the headquarters address above. Copyright n 2004 by Marcel Dekker, Inc. All Rights Reserved. Neither this book nor anypart may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission in writing from the publisher. Current printing (last digit): 10 9 8 7 6 5 4 3 2 1 PRINTED IN THE UNITED STATES OF AMERICA

Preface to the Second Edition

The publication of thefirst edition of the Handbook of Obesity occurred just as the Food and Drug Administration requested the recall of fenfluramine and dexfenfluramine. Each drug alone and in combination with phentermine had been associated with a rash of valvular heart disease. These cases were similar to some seen with the carcinoid syndrome that secretes serotonin. There was an accumulation of material on the aorticvalves in the heart that made them leaky. The good news is that many of these valvular lesions have been reversible when the drugs were discontinued, and there are no cases known to us of progression after the drugs were stopped. Thus, at the time the first edition of the Handbook of Obesity was published, the chapters dealing with fenfluramine and combination therapy were already out of place. Inaddition, there were few drug treatments on the horizon. In spite of this negative impact, the scientific advances preceding the publication of the first edition had been substantial. As we began to plan the second edition, we reviewed each of the 49 chapters in the first edition. The major changes were in the therapeutic area, where many new drugs were under evaluation and where new strategies forprevention of obesity were being evaluated. Based on these advances in the therapeutic area, we have added 12 new chapters, which made a substantially

longer volume with 61 chapters. We have thus decided to divide the handbook into two separate volumes. The first deals with the prevalence, etiology, and consequences of obesity. In the second volume we have included the chapters dealing with...
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