This themed issue is published at a time when the world is critically preoccupied with saving lives being lost to the Covid 19 pandemic. Attention to the obesity epidemic, along with other, equally important public health threats, has been eclipsed as providers and systems cope with the ongoing pandemic and its consequences. When the editorial board conceived this themed issue, it recognized that obesity is a prevalent disease associated with poor health outcomes across the short and long term and across populations and generations. Even in the early stages of the Corona virus pandemic, we see evidence that obesity is associated with poorer outcomes (Richardson et al., 2020). And so, although we focus on the best response to the current crisis, we appreciate the importance to advance knowledge on obesity prevention and management.

Obesity remains a disease whose consequences carry significant morbidity and mortality. The relationship with hypertension and diabetes are well documented, as well as cancer and other morbid conditions. It can be considered the primary issue in the cluster of problems treated by nurse practitioners and a multitude of other health care professionals. The more we know about the etiologies and treatments for this disease, the better we can serve our patients. This issue discusses the obesogenic environment and its effect on health. It advances our knowledge of the physiologic interplay of the gut microbiome and its relationship to obesity and provides current evidence regarding the deleterious effects of excess adipose tissue on the body. As with so many other complex disease states, the earlier the diagnosis and treatment, the better. For although an obesity epidemic exists, the notion of obesity as a disease has yet to take hold in society. It is up to us to translate this critical information to our patient populations to greatly increase prevention strategies such as exercise, increased physical activity, and diet. There is emphasis in this issue on the crucial relationship of activity and exercise to the prevention and treatment of obesity.

The contributors move us well past the dogma of "calories in-calories out" by sharing their expertise in obesity diagnosis and treatment, genomics and physiology, exercise, and mentoring. Person-centered lexicon is encouraged, and the underdiscussed issue of weight bias is presented. These contributions steer us to tailor interventions based on sound mores, evidence, applicability, and scalability.

The challenges to successful obesity management are many and include everyday life conditions that are not easily controlled. A person-centered, evidence-based approach to clinical and population-based health care is a hallmark of the nurse practitioner profession. In this issue, the authors address important precepts and relevant evidence regarding the complexities of obesity; advancing our knowledge base while providing firm support on which to improve our practice. An integrated approach to obesity treatment recognizes the multitude of factors to address when planning with a patient. It appreciates the individual; that is, their timeline, their resources, motivation, literacy, ability to self-care and self-monitor, exercise, diet, beliefs, and values (to name a few). Our responsibility is to provide evidence-based content using relevant technology, while using our relationship to build sustainable changes. It is hard work for all involved.

Integration and synergy with other health care providers has proven to yield good patient outcomes. But systemic change is necessary to reduce the burden of this disease, which leads to poor health care outcomes, exacerbates inflated health care costs, and is often associated with stigma and societal marginalization. This issue contributes to this goal by providing cutting edge information and research by nurse practitioner experts, researchers, and thought leaders in obesity care.

When this issue was conceived, no one could predict that its production would occur during a global, deadly pandemic. The team for this themed issue did their work despite facing life-altering experiences of their own. I would like to acknowledge and thank all who participated. This is a time of rapid change for everyone. The way health care is delivered has already seen exponential change and will continue to shape how we work with our patients to prevent and manage obesity.

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