FIGURE 2-1 Data are from the National Health and Nutrition Examination Surveys (NHANES) II (1976–1980) and III (Phase 1, 1988–1991), conducted by the National Center for Health Statistics, and target goals are from Healthy People 2000 (DHHS, 1991).

the United States, increasing the population's risk for chronic diseases such as hypertension, other cardiovascular and cerebrovascular diseases, some forms of cancer, and non-insulin-dependent diabetes mellitus. Obesity is a heterogeneous disease in which genetic, environmental, psychological, and other factors are involved. It occurs when energy intake exceeds the amount of energy expended over time. Only in a small minority of cases is obesity caused by illnesses such as hypothyroidism or the result of taking medications, such as steroids, that can cause weight gain.

One remarkable feature of obesity is that its management requires a great deal of effort from the individual. Health-care providers or counselors can offer only advice and technical support at this time. In virtually every other field that involves a chronic disease, there is the expectation that drugs are required and may be effective in treating and possibly curing these diseases. While researchers expect that the development and long-term use of new drugs and combinations of drugs will help in the chronic management of obesity, few drugs are available at present. For



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