How Effective Are We In Achieving Our Goals

Assuming that weight loss is desirable, can we really achieve it? Behavioral modifications such as diet and exercise, while first-line recommendations, remain ultimately largely ineffective at maintaining long-term weight loss at desirable levels. Despite intensive research efforts in the field, it remains to be fully elucidated which diet or dietary pattern, if any, is the most beneficial in terms of reducing weight loss or improving metabolic profile. This is related, in part, to the difficulty in reproducing in an experimental setting the real life dietary patterns of populations, let alone to perform long-term clinical trials utilizing these specific diets or dietary patterns. Thus, although data from interventional studies have started to emerge, current dietary recommendations are based mainly on expert opinion, based, to a large extent, on observational studies (which do not prove causality), expected outcomes and risk-benefit estimations.

We discuss herein the effects of different treatment modalities, including behavioral modifications such as diet and exercise, pharmacotherapy, and bariatric surgery, on obesity and its comorbidities, including cardiovascular risk factors, risk for malignancy, bone disease, biliary disease, and overall quality of life. Pertinent randomized controlled clinical trial and meta-analysis data are discussed and when these are not available, or do not fully elucidate relevant questions, data from observational studies and case series are reported in the relevant chapters of this book.

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