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Reviews and Notes: Obesity: Theory and Therapy

Obesity: Theory and Therapy Second edition. Albert J. Stunkard, and Thomas A. Wadden; eds. 388 pages. New York: Raven Press; 1992. $59.00. As one who is interested in the care of obese patients, I have welcomed the increased focus on obesity brought forth by the Congressional hearings on the commercial weight loss industry, the National Institutes of Health Conferences on Gastrointestinal Surgery for Severe Obesity and Methods for Voluntary Weight Loss and Control, and the recent publication of several medical textbooks on the subject. These forums and publications have clearly shown that to treat effectively the overweight patient, one must appreciate the diversity of factors that constitute the disease of obesity. Stunkard and Wadden are to be commended for providing an excellent and updated resource for those interested in the scientific background and clinical aspects of obesity management. Written primarily for clinicians, the book covers the latest findings on the theory (the first 10 chapters) and therapy (the last 11 chapters) of human obesity. This organization allows readers to easily pick and choose between sections and chapter topics that they find especially relevant and interesting. I found several chapters particularly outstanding, including Sjostrom's review of obesity-related morbidity and mortality and Ravussin and Swinburn's discussion of energy metabolism. Some topics are nicely paired between sections, such as Neural Mechanisms of Feeding and Pharmacological Aspects of Appetite (chapters 3 and 4) with Appetite-Suppressant Drugs (chapter 16). In general, the chapters are well-written and cite current references. The most appealing aspect of this book is the broad selection of topics. As a reflection of the diverse perspectives of the disease, the 30 contributing authors, all experts in their field, provide up-to-date reviews on a variety of eclectic subjects, including physiologic regulation of energy, dietary obesity, restrained eating, cultural (anthropologic) perspectives, relapse prevention, childhood obesity, talking with patients, and public health approaches to obesity. Despite the book's overall appeal, the topics covered are selective rather than comprehensive. Readers interested in extensive reviews of fields such as surgical approaches and postoperative management, very-low calorie diets, intermediary metabolism, animal models of obesity, and body composition techniques must consult other resources. In general, experienced and inexperienced clinicians will find this book readable and informative. The editors' goal of providing an authoritative account of what is known about obesity today is definitely achieved.