Sharon R. Akabas, PhD, Director, MS Program, Associate Director of Educational Initiatives, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York City, NY, USA

Sally Ann Lederman, PhD, Special Lecturer, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York City, NY, USA

Barbara J. Moore, PhD, President and CEO, Shape Up America!, Clyde Park, MT, USA

Contributors

Jeanine B. Albu, MD, Associate Director, Endocrinology Fellowship Training Program, Division of Endocrinology and Metabolism, St. Luke’s Roosevelt Hospital Center, New York City, NY, USA

David B. Allison, PhD, Professor of Biostatistics, Department of Biostatistics, School of Public Health University of Alabama at Birmingham, AL, USA

Georgina Ankra-Badu, Whitehaven, Cumbria, United Kingdom

Louis J. Aronne, MD, Clinical Professor of Medicine at Weill Cornell Medical College, Director, Weill Cornell’s Comprehensive Weight Control Program, New York City, NY, USA

Jamile A. Ashmore, PhD, Director, Behavioral Medicine Center, Plano, TX, USA

Ninia Baehr, MA, RN, Department of Health and Human Development, Montana State University, Bozeman, MT, USA

Tesfaye M. Baye, PhD, Assistant Professor, Divison of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Leora Benson, MS, Research Technician, New York Obesity Research Center, St. Luke’s-Roosevelt Hospital & Institute of Human Nutrition, Columbia University, New York City, NY, USA

Bonnie Bernstein, PhD, Adjunct Professor, Teachers College, Columbia University, New York City, NY, USA

Marc Bessler, MD, Professor of Clinical Surgery, Chief, Division of Minimal Access/Bariatric Surgery, Department of Surgery, College of Physicians and Surgeons, Columbia University, New York City, NY, USA

Steven N. Blair, PED, Professor, Department of Exercise Science and Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

George A. Bray, MD, Boyd Professor, Chief, Division of Clinical Obesity and Metabolism, Pennington Biomedical Research Center, Baton Rouge, LA, USA

Meghan L. Butryn, PhD, Research Assistant Professor, Department of Psychology, Drexel University, Philadelphia, PA, USA

Angela Calabrese-Barton, PhD, Professor, Department of Teacher Education, Michigan State University. East Lansing, MI, USA

Susan Carnell, PhD, Research Fellow, PhD New York Obesity Research Center, St. Luke’s-Roosevelt Hospital & Institute of Human Nutrition, Columbia University, New York City, NY, USA

Vicki L. Clark, PhD, Post-Doctoral Fellow, Department of Psychology, Drexel University, Philadelphia, PA, USA

Maria C. Coletta, PhD, Post-Doctoral Fellow, Department of Psychology, Drexel University, Philadelphia, PA, USA

Isobel R. Contento, PhD, Mary Swartz Rose Professor of Nutrition and Education, and Coordinator, Program in Nutrition, Department of Health and Behavior Studies, Teachers College, Columbia University, New York City, NY, USA

Issa Coulibaly, PhD, Post-Doctoral Fellow, Department of Biostatistics, Section on Statistical Genetics, University of Alabama at Birmingham, AL, USA

Sharron Dalton, PhD, RD, Professor, Department of Nutrition, Food Studies, and Public Health Steinhardt School of Culture, Education, and Human Development, New York University, New York City, NY, USA

Daniel Davis, DO, Chief of Bariatric Surgery, Department of Surgery, Stamford Hospital, Stamford, CT, USA

Nichola Davis, MD, MS, Assistant Professor, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University, and Montefiore Medical Center, Bronx, NY, USA

Mary DiGiorgi, MS, MPH, Columbia University Center for Metabolic and Weight Loss Surgery, New York Presbyterian Hospital, New York City, NY, USA

Michael Eriksen, ScD, Professor and Director, Institute of Public Health, Georgia State University, Atlanta, GA, USA

Anthony W. Ferrante Jr. MD, PhD, Dorothy & Daniel Silberberg Assistant Professor of Medicine, Department of Medicine, Naomi Berrie Diabetes Center, Columbia University, New York City, NY, USA

Gary D. Foster, PhD, Professor, Medicine and Public Health, Director, Center for Obesity Research and Education, Temple University School of Medicine, Philadelphia, PA, USA

I. J. Frame, MS, MD/PhD Candidate Albert Einstein College of Medicine, Bronx, NY, USA

Georita Frierson, PhD, Department of Psychology, Southern Methodist University, Dallas, Texas, USA

Dympna Gallagher, EdD, Associate Professor of Nutritional Medicine, Department of Medicine St. Luke’s-Roosevelt Hospital the Institute of Human Nutrition, Columbia University, Director, Human Body Composition Core Laboratory, Associate Director, New York Obesity Nutrition Research Center, New York City, NY, USA

James O. Hill, PhD, Professor of Pediatrics and Medicine, Director, Center for Human Nutrition, Director, Colorado Nutrition Obesity Research Center (NORC), University of Colorado School of Medicine, Denver, CO, USA

Carmen R. Isasi, MD, PhD, Assistant Professor, Department of Epidemiology & Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA

Wahida Karmally, DrPH, RD, CDE, CLS, Director of Nutrition, Irving Institute for Clinical and Translational Research, Columbia University, New York City, NY, USA

Pamela A. Koch, EdD, Executive Director of the Center for Food & Environment, Program in Nutrition, Department of Health and Behavior Studies, Teachers College, Columbia University, New York City, NY, USA

Aliki Kosteli MS, PhD, Post-Doctoral Fellow, Department of Medicine, Naomi Berrie Diabetes Center, Institute of Human Nutrition, Columbia University, New York City, NY, USA

Janet D. Latner, PhD, Associate Professor, Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA

Rodney Lyn, PhD, Assistant Professor, Institute of Public Health, Georgia State University, Atlanta, GA, USA

Edward Mandelbaum, LCSW, Manhattan Institute for Psychoanalysis, New York City, NY, USA

Barbara J. Moore, PhD, President and CEO, Shape Up America!, Clyde Park, MT, USA

Melissa A. Napolitano, PhD, Associate Professor, Kinesiology and Public Health, Temple University School of Medicine, Philadelphia, Pa, USA

Cathy A. Nonas, MS, RD, Director of the Physical Activity and Nutrition Program, New York City Department of Health and Mental Hygiene, New York City, NY, USA

Xavier Pi-Sunyer, MD, MPH, Professor of Medicine, Columbia University College of Physicians and Surgeons, Chief, Division of Endocrinology, Diabetes and Nutrition, St. Luke’s-Roosevelt Hospital, Director, New York Obesity Research Center, St. Luke’s-Roosevelt Hospital, New York City, NY, USA

Rebecca M. Puhl, PhD, Director of Research, Rudd Center for Food Policy & Obesity, Yale University, New Haven, CT, USA

Nancy L. Restuccia, MS, RD, CDN, Bariatric Dietician, Columbia University Center for Metabolic and Weight Loss Surgery, New York Presbyterian Hospital, New York City, NY, USA

Karen Reznik Dolins, EdD, RD, Adjunct Associate Professor, Teachers College, Columbia University, Sports Dietitian, Columbia University Athletics, New York City, NY, USA

Michael Rosenbaum, MD, Professor, Clinical Pediatrics and Medicine, Associate Program Director, General Clinical Research Center, College of Physicians & Surgeons, Columbia University, New York City, NY, USA

Beth Schrope, MD, PhD, Assistant Surgery, Department of Surgery, College of Physicians and Surgeons, Columbia University, New York City, NY, USA

Daniel Shriner, PhD, Research Fellow, Center for Research on Genomics and Global Health, The National Institutes for Health (NIH), Bethesda, MD, USA

Albert J. Stunkard, MD, Professor, Department of Psychiatry, Founder, Founded the Center for Weight and Eating Disorders. University of Pennsylvania, Philadelphia, PA, USA

Judy Townsend, PA-C, Weill Cornell’s Comprehensive Weight Control Program, New York City, NY, USA

Megan Tubman, MS, RD, Nutritionist, Fresh Start Nutrition Studio, LLC, New York City, NY, USA

Akuenzunkpa Ude, MD, Department of Surgery, New York University, Bellevue Hospital, New York City, NY, USA

Meredith Urban-Skuro, MS, RD, Bariatric Dietician Columbia University Center for Metabolic and Weight Loss Surgery, New York Presbyterian Hospital and Valley Hospital, New York City, NY, USA

Ileana Vargas, MD, Assistant Clinical Professor of Pediatrics, Department of Pediatrics, Morgan Stanley Children’s Hospital of New York Presbyterian and Naomi Berrie Diabetes Center, New York City, NY, USA

Joseph R. Vasselli, PhD, Associate Research Scientist, Department of Medicine, St. Luke’s-Roosevelt Hospital Center and The Institute of Human Nutrition, Columbia University, New York City, NY, USA

Brian Wansink, PhD, John S. Dyson Professor of Marketing, Department of Applied Economics and Management, Director, Cornell Food and Brand Lab, Cornell University, Ithaca, NY, USA

Jane Wardle, PhD, Professor in Clinical Psychology and Director of the Health Behaviour Unit Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, United Kingdom

Rena R. Wing, PhD, Professor, Department of Psychiatry & Human Behavior, Director, Weight Control and Diabetes, Research Center, Brown Medical School, Brown University, Providence, RI, USA

Judith Wylie-Rosett, RD, EdD, Professor, Department of Epidemiology & Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA

Jung-Eun Yim, PhD, Research Professor, Research Institute of Clinical Nutrition, Kyung Hee University, Seoul, Korea

Progress in raising awareness of obesity as a health issue has certainly been made, but there has been little progress in stemming the epidemic. We now have nearly 75 million Americans categorized as “obese” and more than 17 million are categorized as “severely obese.” Of greatest concern, an estimated 12 million children are obese with 2.5 million severely obese.

Now we are learning that the offspring of obese and severely obese parents are at greater risk of obesity, introducing a new understanding of the way the obesity epidemic is self-propagating through epigenetic pathways. With so many millions of Americans of childbearing potential entering pregnancy and parenthood in the obese condition, this represents a deepening of the crisis.

A broadly increased understanding of the many causes and consequences of obesity is urgently needed. The field has made remarkable strides enlightening us about the endocrine function of fat cells and how leptin—a protein synthesized by fat cells—crosses the blood-brain barrier to mediate the communication between body fat depots and regulatory centers in the brain that influence appetite and energy balance. But much more work needs to be done, particularly to develop effective prevention and treatment approaches.

The publishing world is highly competitive and up to now, a comprehensive textbook such as this one did not exist. The editors and authors of this volume have labored for more than 3 years to create a textbook suitable for college level students and those who are beginning their graduate education. Their goal was to attract bright new minds to the field of obesity to help us devise innovative research, invent new medical devices, discover new therapeutic agents for treatment, and develop public health solutions to help us stop and reverse the epidemic. I am proud to support their effort as I share their hope that making information about the complex nature of obesity more accessible to students will increase the likelihood of finding urgently needed answers to these highly perplexing problems.

Now I am calling upon you, the reader, to help us move the field forward and make America a healthier place to live, learn, work and play. There is no doubt that it takes a nation to stem obesity and regardless of your chosen career path, we call upon you to be a part of the solution.

C. Everett Koop, MD, ScD

13^th U. S. Surgeon General and

Founder of Shape Up America!

Hanover, NH

November 2011

Sharon R. Akabas, Barbara J. Moore and Sally Ann Lederman

A major theme of this book is to understand the complexity of the factors that underlie energy balance and weight, with the goal of understanding the overweight or obese person. Understanding is an attribute I have had modeled for me my whole life, by my parents, Eli and Rebecca Freedman, and my siblings, Karen Jimmerson, Jay Freedman, Barry Freedman, Beth Rosen, Jayne Quinn, Judy Fask, and Barbara Freedman. This modeling has been continued in my own family by my husband, Myles, and children, Sam, Leor, and Reuben. I am grateful to all of them for their love, humor, support, and patience during this arduous process.

Sharon R. Akabas

I would like to thank Sharon R. Akabas for giving me the opportunity to collaborate on this book and other exciting projects, enabling me to work with two smart and dear friends, while learning things of great interest and importance, both from the work itself and from the two of them.

Sally Ann Lederman

I would like to extend special thanks to my husband, Denis Prager, for his patience and support during the years of bringing this project to fruition. He is my toughest critic and best editor. I also wish to thank my postdoctoral and lifelong professional mentor, Dr Judith S. Stern, for her staunch commitment to clear communication and for instilling a similar commitment in her students.

Barbara J. Moore

Sharon Akabas and Barbara Moore would like to jointly acknowledge Sally Ann Lederman. She is always willing to serve as a very thoughtful sounding board and is extremely generous with her time. Over the years she has been one of our toughest and most valuable critics. Without her unflagging ability to stay on task, solve problems, and get the job done this book would not exist.