The prevention and treatment of overweight and obesity. Summary of the advisory report by the Health Council of The Netherlands.

This article presents the highlights of an advisory report on the prevention and treatment of overweight and obesity. The report, which was produced by the Health Council of The Netherlands, incorporates the most recent developments and projected scientific breakthroughs in this field. The prevalence of overweight and obesity has taken on epidemic proportions. In The Netherlands, as elsewhere, there is a steady rise in the number of individuals suffering from overweight or obesity. Since it is associated with serious health problems, obesity (and to a lesser extent overweight) leads to increased costs for the healthcare system. Food consumption surveys and studies on time trends in physical activity patterns have revealed that the increased prevalence of obesity is due to an increasing lack of exercise, combined with relative overconsumption. A healthy diet (including plenty of fruit, vegetables and cereal products) and at least one hour a day of moderate physical activity are recommended for the maintenance of energy balance and for the prevention of weight gain. While genetic factors play a part in the development of overweight and obesity, environmental factors appear to be of overriding importance. The so-called 'obesogenic environment' prompts individuals to eat more and to take less exercise. There are still no effective intervention strategies for the prevention of weight gain. However, the explosive increase in the prevalence of obesity and of its associated serious medical problems demands a common-sense approach involving preventive interventions, which are based on modern views of health promotion. These interventions require a broad coalition of actors, in which local and national authorities, industry, the healthcare system and the population at risk must each shoulder their own share of responsibility. The primary aim of obesity treatment should be a long-lasting weight loss of about 10%. Even this relatively small weight loss can produce significant health gains. Treatment methods must involve an integrated (lifestyle) approach, dependent on the amount of overweight involved and on the presence of comorbidity. Obesity should be treated chronically and prevention of weight regain must be part of any obesity treatment programme.