The prevention of weight gain rather than a reduction in obesity prevalence is a goal that should apply equally to both populations and individuals and is appropriate to nearly all members of society regardless of their initial weight. Criteria have not been specifically set for obesity prevention, but it would seem appropriate to ensure that individuals avoid weight gain which has the potential to impact appreciably on their ''well-being'' and capacity to live a full life. However, this general definition leads to a plethora of issues because in affluent Western societies women, in particular, are striving to prevent even modest weight increases often when they are within the normal BMI range. The concept of well-being, therefore, involves recognition that the quality of life of children and adults is in part determined by their cultural setting and not just by whether or not they have symptoms relating to physical comorbidities. Prevention strategies could be defined for simplicity as strategies which (1) allow individuals to remain within the normal BMI range and restrict adult weight gain to <5 kg, (2) prevent further weight gain in existing overweight and obese individuals, and (3) successfully prevent weight regain in overweight and obese patients who have lost a reasonable amount of weight (e.g., >5%). In the SIGN Guidelines, weight maintenance was defined as the weight regain of <3 kg long term (i.e., >2 years)
(12). These three categories of successful prevention are chosen arbitrarily but demand very similar strategies.
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