^*Division of Endocrinology, Diabetes, and Nutrition, Columbia University College of Physicians and Surgeons, St. Luke's-Roosevelt Hospital Center, New York, New York.

Correspondence: F. Xavier, Pi-Sunyer St. Luke's-Roosevelt Hospital Center, 1111 Amsterdam Avenue, Room 1020, New York, NY 10025. E-mail: fxp1@columbia.edu

Abstract

Intervention in weight management should begin before the onset of the metabolic syndrome. Therapeutic lifestyle changes (e.g., diet and physical activity) comprise the cornerstone of care for overweight and obese patients. Behavior modification approaches are useful in facilitating adherence to specific dietary regimens. Pharmacotherapy is an option for patients with a BMI >30 kg/m² or for those with a BMI of 27 to 30 kg/m² and two or more risk factors, who have failed on diet and exercise alone. To date, the U.S. Food and Drug Administration has approved three weight loss agents: sibutramine, orlistat, and phentermine.