research to understand the fundamental causes of obesity, particularly at the molecular and genetic levels, is enormously important. In addition, the behavioral and environmental influences on the expression of obesity need to be much better understood. The genetic and environmental determinants of obesity and its associated comorbidities vary among population groups, and the variation and reasons for this variation are important areas of research. In addition, research is needed on cognitive-behavioral approaches to increase success at long-term weight loss and maintenance and to further understand the contributions of diet and physical activity in achieving successful weight management. Furthermore, it would be useful to determine the mechanisms by which antiobesity drugs and gastric surgery promote weight loss.
While research should eventually uncover the causes of obesity and lead to this disease being better managed, prevented, and treated, the application of scientific findings alone is rarely enough to resolve public health problems. Public policies are needed to translate the research findings to the lay public and to apply what is already known about successful weight management. We have three major public-policy recommendations:
Obesity should be acknowledged as one of this country's most important nutrition-related diseases, which has important consequences for the funding of research by government, foundations, and private agencies; for health-care reform; and for oversight of the weight-loss industry by regulatory agencies.
There must be increased recognition and support for obesity research at the genetic, molecular, and cellular levels that will aid our understanding of the causes of obesity and its associated comorbidities.
A more aggressive policy is required to inform the public and health-care providers about the nature of obesity, the difficulties inherent in treating this disease, and the need for susceptible individuals to take steps to prevent its occurrence or minimize its development. Health-care providers in particular should learn more about obesity and its treatment.
Because successful weight management has proven an elusive goal for most obese individuals in the United States, the marketplace has provided many legitimate as well as unfounded products and services. Improving the rate of success at weight management requires would-be dieters to understand that gimmicks, from weight-loss pills to esoteric diets, either are totally ineffectual or are no more than small countermeasures to an incompletely understood disorder of energy balance. Furthermore,