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ForewordObesity is an escalating epidemic of alarming proportions in the United States, and a serious health crisis looms on our horizon. Recent data from a national survey indicate that one third of adult Americans can be classified as obese, as compared with one quarter a decade earlier. This translates to 58 million American adults (32 million women and 26 million men) who are obese and at risk for obesity-related health problems. Americans have gained an average of 8 pounds per person (an aggregate gain of nearly 2 billion pounds of fat tissue) in the past ten years. Children and adolescents in the United States and much of the Western world are also heavier than ever. At the same time, tomes of research now attest to the serious health risks of excess weight. The medical evidence is compelling, and undebatable, that obesity leads to high blood pressure, adult-onset diabetes, abnormal cholesterol levels, and heart disease. Overweight also contributes to the risk of stroke, certain cancers (particularly of the colon, breast, prostate, and uterus), gallstones, certain forms of arthritis, reduced quality of life, and premature death. In our research in the Harvard Nurses' Health Study, we found that nearly one quarter of all deaths in nonsmoking women were attributable to overweight, supporting the national estimate of 300,000 obesity-related deaths in the United States each year. Even modest weight loss among theV I i