and Medical Sciences BHF Glasgow Cardiovascular Research Centre University of Glasgow Glasgow, UK
Kyra Sim Metabolism & Obesity Services Royal Prince Alfred Hospital Camperdown, New South Wales, Australia
Stephen J. Simpson Charles Perkins Centre and School of Life and Environmental Sciences The University of Sydney Sydney, New South Wales, Australia
Michael R. Skilton Boden Initiative Charles Perkins Centre University of Sydney Sydney, New South Wales, Australia and Sydney Medical School Faculty of Medicine and Health The University of Sydney Sydney, New South Wales, Australia and Sydney Institute for Women, Children and their Families Sydney Local Health District Sydney, New South Wales, Australia
Arianne N. Sweeting Boden Initiative Charles Perkins Centre University of Sydney Sydney, New South Wales, Australia
Boyd Swinburn School of Population Health University of Auckland Auckland, New Zealand and GLOBE (Global Obesity Centre) Deakin University Melbourne, Victoria, Australia
Mishel Unar‐Munguia Centro de Investigación en Nutrición y Salud Instituto Nacional de Salud Pública Cuernavaca, Mexico
Lesly Véjar Centro de Investigación en Nutrición y Salud Instituto Nacional de Salud Pública Cuernavaca, Mexico
Ann Verhaegen Department of Endocrinology, Diabetes and Metabolism Antwerp University Hospital Edegem, Belgium
Thomas A. Wadden Department of Psychiatry Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA, USA
Wilma Waterlander Department of Public and Occupational Health Amsterdam UMC University of Amsterdam Amsterdam, the Netherlands
Mariel White Centro de Investigación en Nutrición y Salud Instituto Nacional de Salud Pública Cuernavaca, Mexico
John P.H. Wilding Department of Diabetes and Endocrinology Liverpool University Hospitals NHS Foundation Trust Aintree University Hospital Liverpool, UK and Department of Cardiovascular and Metabolic Medicine Institute of Life Course and Medical Sciences University of Liverpool Aintree University Hospital Liverpool, UK
Brendon J. Yee Sleep and Circadian Research Group (CIRUS) Woolcock Institute of Medical Research University of Sydney Sydney, New South Wales, Australia and Centre for Respiratory Failure and Sleep Disorders Royal Prince Alfred Hospital Sydney, New South Wales, Australia
Preface
Clinical Obesity in Adults and Children originated in 1998 from the Editors’ perception of a need for a textbook on obesity which emphasized obesity as a disease entity by reviewing the scientific basis and addressing the clinical and practical aspects of the condition. The introduction concluded that obesity management and research had reached a watershed at the end of the century, given the increasing concerns about the problem for future generations. As we enter the third decade of the new century, such concerns have not only materialized but have been exceeded.
The fourth edition of Clinical Obesity has been written during a pandemic caused by the SARs-CoV- 2 coronavirus. Many contributing authors were actively engaged in the frontline of health care treating patients suffering from this virulent virus. The additional morbidity and mortality of COVID-19 infections associated with excess body weight have emphasized the urgent need for the effective prevention and treatment of obesity.
In the context of a pandemic, this new edition of Clinical Obesity concludes with a timely chapter on the global syndemic. The notion of a syndemic was first conceived by Merrill Singer, a medical anthropologist, in the 1990s. Writing in The Lancet in 2017, Singer argued that a syndemic perspective reveals biological and social interactions that are important for prognosis, treatment, and health policy. A syndemic is not merely a comorbidity; syndemics are characterized by biological and social interactions between conditions and states, interactions that increase a person’s susceptibility to harm or worsen their health outcomes. The Lancet Commission on Obesity proposed that obesity, undernutrition, and climate change constitute a syndemic. Malnutrition in all its forms, including obesity, undernutrition, and other dietary risks, is the leading cause of poor health globally. Climate change is a fundamental part of this because of its sweeping effects on the health of humans and the natural systems that we depend on and underpins the way that we live.
In this edition of Clinical Obesity, we focus on the textbook’s original objectives with chapters on the causes of obesity, obesity as a disease, the management of adult obesity, and childhood obesity. We also include a section on policy approaches that underline the importance of effective and sustainable policies free from political and commercial interference.
We, the editors, have spent long careers concerned about obesity, and we share an exasperation that so little has been accomplished worldwide in reversing its spiraling prevalence and its detrimental effects across all ages. Certainly, the understanding of the science and medical consequences of obesity has grown exponentially, but the drivers of excessive weight gain remain obvious in all societies, yet meaningful policy recommendations fail to be developed or translated into practice, and the economic burden from obesity grows.
We hope that this latest edition of Clinical Obesity enables its readers to understand the complexity of obesity better, both within society and the clinical setting, and provides inspiration and knowledge for those tasked with managing and tackling the condition.
We are most grateful to our co-editors for this edition, Sarah Armstrong, Arianne Sweeting, and John Wilding, for their considerable help and support in bringing this new edition to fruition. We hope that the experience will encourage them to take over the “baton” for future editions of Clinical Obesity.
Peter G. Kopelman, Ian D. Caterson, and William H. DietzLondon, Sydney, and Washington, DC
Dedication
Peter G. Kopelman
Peter was an editor for each of the four editions of Clinical Obesity in Adults and Children and lead editor for three. He died just before this edition was completed, but he asked us to ensure it was finished.
Peter was a clinician, a researcher, a teacher, and an academic leader. His research was initially into the genetics of obesity, but this developed into a wider interest in many aspects of obesity, particularly its management. He led the production of clinical guidelines, and his focus was always on the patient with obesity, and with equity. He was a leader in medical education and was executive dean of the Faculty of Health at The University of East Anglia, and then returned as principal at St George's Hospital in London, where he had trained. He became an academic leader within the Royal College of Physicians and the University of London. He was one who cared for others and strove to provide the best care for his patients, and mentoring and leadership for his students and colleagues.
For the two of us, Peter was a wonderful colleague and friend who organised and led us through the production of the
