early Stage squareObesity is a medical condition in which there is an excess of adipose tissue. The most commonly used method to evaluate obesity is the body mass index (BMI), which is equal to weight/height2 (kg/m2). A BMI of 30 is often used as a threshold for obesity; however, studies suggest that morbidity and mortality start to rise when BMIs are ≥25.

Obesity is associated with an increased risk of various health problems, including cardiovascular disease, hyperlipidemia, Type 2 diabetes, obstructive sleep apnea, osteoarthritis, and some malignancies. Consequently, obesity has been shown to reduce life expectancy by 6 to 7 years on average.

Obesity is the second leading cause of preventable death in the U.S., accounting for 300,000 deaths per year, and the prevalence is on the rise. Data from the National Health and Nutrition Examination Surveys (NHANES) shows that the percentage of the adult population with obesity (BMI >30) has increased from 14.5% (between 1976 and 1980) to 33.9% (between 2007 and 2008).

Current Treatment

The primary goal of treatment is to improve obesity-related complications and reduce the risk of developing further comorbidities.

First-line therapy for obesity consists of lifestyle modification through diet, physical exercise, and behavioral therapy.

Medications such as those that affect the hypothalamus to increase satiety and decrease hunger as well as those that inhibit lipases to help block digestion and absorption of dietary fat.

Bariatric surgery can also be considered for some patients with higher BMI’s. These include restrictive surgeries that are intended to limit the amount of food the stomach can hold and slow gastric emptying as well as restrictive-malabsorptive by-pass procedures that combine gastric restriction and selective malabsorption.

Focused Ultrasound Research

Focused Ultrasound is a non-invasive modality for the ablation of tissue. Thermal ablation allows for cell death in a precise location with minimal damage to surrounding tissue. Pre

clinical research and trials in human volunteers have demonstrated that FUS can safely remove adipose tissue. To date, these studies have only been performed in non-obese individuals for the purposes of body contouring. Further studies are needed to evaluate the potential of FUS as a fat-reducing treatment in obese patients. 

Notable Papers

Winter PM, Lanier M, Partanen A, Dumoulin C. Initial investigation of a novel noninvasive weight loss therapy using MRI-Guided high intensity focused ultrasound (MR-HIFU) of visceral fat. Magn Reson Med. 2016 Jul;76(1):282-9. doi: 10.1002/mrm.25883. Epub 2015 Aug 18.

Saedi N, Kaminer M. New waves for fat reduction: high-intensity focused ultrasound. Semin Cutan Med Surg. 2013;32(1):26-30.

Jewell ML, Desilets C, Smoller BR. Evaluation of a novel high-intensity focused ultrasound device: preclinical studies in a porcine model. Aesthet Surg J. 2011;31(4):429-34.

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