The Metabolic Syndrome and Obesity

With the reduction in food prices and distortion of commercially profitable products resulting from federal subsidies of corn, sugar, and rice, the food industry has been able to produce cheap, good-tasting, energy-dense foods and can sell them cheaply in large portion sizes. The Metabolic Syndrome and Obesity presents an up-to-date survey of the current scientific understanding of obesity and the metabolic syndrome, as well as an overview of the most significant changes to the field over the past 30 years. By first presenting a historical context for overweight, the book drives home the point that obesity is by no means simply a contemporary problem, and its continued existence means that we neither understand it, nor have developed effective therapies. The Metabolic Syndrome and Obesity is a comprehensive reference for the treatment of obesity in two parts. Part I, The Problem, examines the entire scope of the obesity epidemic, including epidemiology and history, costs of treatment, pathology, clinical types, age-related issues, and general health risks. Part II, The Solutions, describes several treatment options including diet, behavior modification, exercise, pharmacological treatment, and surgery. This volume is a thorough reference for obesity and the metabolic syndrome and offers an in-depth assessment of the problem and its myriad potential treatment options. Thirty years ago, I published my first monograph on obesity (Bray, 1976). Many things have changed in these 30 years, but many have remained the same. Preparation of The Metabolic Syndrome and Obesity has given me a chance to survey the changes to the field and to present an update of the scientific information. In retrospect, I conclude that a major component of the current “epidemic” of overweight is not medical, not genetic, not psychological, and will not be effectively treated by “lifestyle” changes that require individual choices. We are all influenced by the prices of the goods we buy. With the reduction in food prices and distortion of commercially profitable products resulting from federal subsidies of corn, sugar, and rice, the food industry has been able to produce cheap, good-tasting, energy-dense foods and can sell them cheaply in large portion sizes. In contrast, foods like fruits and vegetables receive little in the way of subsidies, and are thus more expensive; thus we buy less. Providing more “healthy” food alternatives, as some advocate, will put items with “higher costs” on the shelves and is, in my view, unlikely to alter consumer choices as long as good-tasting, energy-dense foods remain cheap. HISTORICAL CONTEXT FOR OBESITY Obesity was already a problem before my first monograph was published. Between the writing of that monograph and The Metabolic Syndrome and Obesity, I was fortunate enough to find a short book in French, written by an American from Cincinnati named Worthington.