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Nat Rev Dis Primers. 2017 Jun 15;3:17034. doi: 10.1038/nrdp.2017.34.


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Department of Nutrition, Food Science and Physiology/Centre for Nutrition Research, University of Navarra, Edificio de Investigación, calle de Irunlarrea 1, Pamplona 31008, Navarra, Spain.
IDISNA Navarra's Health Research Institute, Pamplona, Spain.
CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain.
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Centre de Recherche de l'Institut universitaire de Cardiologie et de Pneumologie de Québec, and Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, Québec, Canada.
Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan.
Charles Bronfman Institute for Personalized Medicine, Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
Pennington Biomedical Research Center/LSU, Baton Rouge, Louisiana, USA.
IMDEA Food Institute, Madrid, Spain.


Excessive fat deposition in obesity has a multifactorial aetiology, but is widely considered the result of disequilibrium between energy intake and expenditure. Despite specific public health policies and individual treatment efforts to combat the obesity epidemic, >2 billion people worldwide are overweight or obese. The central nervous system circuitry, fuel turnover and metabolism as well as adipose tissue homeostasis are important to comprehend excessive weight gain and associated comorbidities. Obesity has a profound impact on quality of life, even in seemingly healthy individuals. Diet, physical activity or exercise and lifestyle changes are the cornerstones of obesity treatment, but medical treatment and bariatric surgery are becoming important. Family history, food environment, cultural preferences, adverse reactions to food, perinatal nutrition, previous or current diseases and physical activity patterns are relevant aspects for the health care professional to consider when treating the individual with obesity. Clinicians and other health care professionals are often ill-equipped to address the important environmental and socioeconomic drivers of the current obesity epidemic. Finally, understanding the epigenetic and genetic factors as well as metabolic pathways that take advantage of 'omics' technologies could play a very relevant part in combating obesity within a precision approach.

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