Certain populations and individuals may (to be) ______ more prone to obesity than others

The mainstay of treatment for obesity (to be) ____ an energy-limited diet and increased exercise.

In a clinical practice guideline by the American College of Physicians, the following five recommendations (to make) _______________:

1. People with a BMI of over 30 should (to counsel)_________________ on diet, exercise and other relevant behavioral interventions, and (to set) _______ a realistic goal for weight loss.

2. If these goals (not to achieved) _________________, pharmacotherapy can (to offer) __________________. The patient (to need)__________ to be informed of the possibility of side-effects and the unavailability of long-term safety.

3. Drug therapy may (to consist) ______________ of sibutramine, orlistat, phentermine, diethylpropion, fluoxetine, and bupropion. For more severe cases of obesity, stronger drugs such as amphetamine and methamphetamine may (to use) ______________on a selective basis.

4. In patients with BMI > 40 who (to fail) ____________ to achieve their weight loss goals (with or without medication) and who (to develop) _____________ obesity-related complications, referral for bariatric surgery may (to indicate) __________________. The patient (to need) ______________ to be aware of the potential complications.

5. Those requiring bariatric surgery should (to refer) ________________ to high-volume referral centers, as the evidence (to suggest) ___________ that surgeons who frequently (to perform) ______________ these procedures (to have) ______________ fewer complications.

The Health Survey for England (to predict) ____________ that more than 12 million adults and 1 million children (to be) _____________obese by 2010 if no action (to take) _____________.

The prevalence of overweight and obesity in the United States (to make) ________ obesity a leading public health problem. The United States (to have) ______the highest rates of obesity in the developed world. From 1980 to 2002, obesity (to double) ____________ in adults and overweight prevalence (to triple) __________________ in children and adolescents. From 2003-2004, "children and adolescents aged 2 to 19 years, 17.1% (to be) ________ overweight...and 32.2% of adults aged 20 years or older (to be) ______ obese." The prevalence in the United States (to continue) ____________ to rise. The prevalence of obesity (to rise) _____________________continually ____________ for two decades. This sudden rise in obesity prevalence (to attribute) _____________ to environmental and population factors rather than individual behavior and biology because of the rapid and continual rise in the number of overweight and obese individuals. The current environment (to produce) ________________ risk factors for decreased physical activity and for increased calorie consumption.

• Lack of activity: obese people (to appear) ___________ to be less active in general than lean people, and not just because of their obesity. A controlled increase in calorie intake of lean people (not to make) ____________ them less active; correspondingly when obese people (to lose) _______ weight they (not to become) _____________ more active. Weight change (not to affect) _______________ activity levels, but the converse (to seem) ________________to be the case.

• One of the most important (to be) ______is the much lower relative cost of foodstuffs: massive changes in agricultural policy in the United States and Europe (to lead) ___________________ to food prices for consumers being lower than at any point in history. Sugar and corn syrup, two huge sources of food energy, (to be) ______ some of the most subsidized products by the United States government.

• Increased marketing (to play) _____ also _________ a role. The number of advertisements seen by the average child (to increase) ____________ greatly, and a large proportion of these (to be) ________ for fast food and sweets.

• Changes in the price of petrol (i.e. gasoline) (to believe) _____ also _________ to have had an effect, as unlike during the 1970s it (to be) _____ now affordable in the United States to drive everywhere. At the same time more areas (to build) ___________________________ without sidewalks and parks.

• The changing workforce as each year a greater percent of the population (to spend) _______ their entire workday behind a desk or computer, seeing virtually no exercise. In the kitchen the microwave oven (to see) _____________________ sales of calorie-dense frozen convenience foods skyrocket.

• A social cause that (to believe) ______________ by many to play a role (to be) _____ the increasing number of two income households in which one parent no longer (to remain) _________ home to look after the house. This (to increase) ______________ the number of restaurant and take-out meals.

• Low food costs, and intense competition for market share, (to lead) ___ to increased portion sizes — for example, McDonalds french fries portions (to rise) ________ from 200 calories (840 kilojoules) in 1960 to over 600 calories (2,500 kJ) today.

• Increased food production (to be) ____ a probable factor. The U.S. (to produce) _____ three times more food than U.S. residents (to eat) ________.

An aging population may also (to be) _____ a major factor, as the likelihood of becoming obese (to increase) ___ with age.