ABSTRACT
Obesity is becoming the plague of the 21st century. With overweight becoming the norm in most western countries and newly resource-rich countries, two-thirds of adults are overweight or obese (Table 64.1). Every clinician faces the condition and its associated diseases, such as type 2 diabetes, as part of their practice. Obesity and lack of physical activity have the second largest public health impact after smoking. Severe obesity increases the risk of cancer, is associated with multiple other diseases, affects quality of life and reduces life expectancy by 5–20 years. Obese people will more often be of lower social class, unemployed and/or on state benefits. Obesity runs in families and social networks and very few obese people have an identifiable genetic, hormonal basis such as Prader–Willi syndrome. Surgeons encounter the problem of obesity on a daily basis as it affects the treatment of nearly every abdominal pathology in terms of approach and outcomes.
