A health paradox exists in modern America. On the one hand, many people who do not need to lose weight are trying to. On the other hand, most who do need to lose weight are not succeeding. The percentage of Americans whose health is jeopardized by too much weight is increasing.
So begins the statement of the Technology Assessment Panel convened for the National Institutes of Health (NIH) Technology Assessment Conference on Methods for Voluntary Weight Loss and Control. This supplement issue of Annals contains papers presenting the scientific data on which the panel relied to reach its conclusions, as well as the panel's statement. The papers provide important new analyses and state-of-the-art reviews. All papers included in the supplement were subjected to the usual peer review process of the journal.
The supplement begins with overview papers addressing the sociocultural and psychosocial determinants of weight concerns, the descriptive epidemiology of body weight and weight change in cross-sectional and cohort samples of U.S. adults in the 1970s and 1980s, special issues regarding obesity in minority populations, and the medical hazards of obesity. Self-perception of weight status and current weight-loss practices among adults and adolescents in the United States are reported, using results from recent national surveys.
Following a paper that proposes standards for judging successful weight loss, a series of papers examines the evidence for success of various methods of voluntary weight loss. Data submitted by industry sources for the conference and evidence from published clinical research on the effectiveness of caloric restriction regimens and diet composition on weight loss are evaluated. Other strategies for weight loss, including behavior modification, exercise, drug treatment, and settings for weight-loss efforts (medically supervised versus unsupervised approaches and community-based approaches), are examined. A summary paper describes what is known about the attributes of successful approaches to weight loss and control, as well as barriers to success.
The final group of papers examines the benefits and adverse effects of weight loss. This group begins with literature summaries of the short-term positive and negative medical and psychological effects of weight loss. Reviews of epidemiologic data on long-term consequences of weight loss and new analyses of data from several longitudinal studies relating weight change to subsequent death are presented.
In 1985, Annals published a supplement on the first NIH Consensus Development Conference on obesity, "Health Implications of Obesity". The papers contained in that supplement reviewed the epidemiology and health consequences of obesity known at that time. Now, a second step is under way, the scientific search for successful interventions.
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