In defining the therapeutic strategy the clinical evaluation of
obesity relies on ideal body weight tables and the calculation of the
body weight index (kg/m2). The distribution of fat tissue must also be considered, since the increased risk of
cardiovascular disease appears to be associated with the android type of
obesity. A number of factors influence the development of
obesity, including heredity, energy balance and appetite, which is under physiologic and psychological control. A balanced hypocaloric diet remains the basic approach to weight control as it alone provides nutritional education. Under medical supervision, unbalanced diets, such as the
protein-sparing modified fast, have been shown to be very effective. The surgical treatment of
morbid obesity is controversial, although good results are claimed for
gastroplasty. Whatever the approach, appropriate supportive measures must be included in order to modify behavior towards food and maintain
weight loss.