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Endocr Rev. 2017 Aug 1;38(4):267-296. doi: 10.1210/er.2017-00111.

Obesity Pathogenesis: An Endocrine Society Scientific Statement.

Author information

1
Diabetes Institute, University of Washington, Seattle, Washington 98109.
2
Department of Surgery, University of Michigan, Ann Arbor, Michigan 48109.
3
Naomi Berrie Diabetes Center and Department of Pathology and Cell Biology, Columbia University, New York, New York 10032.
4
Center for Public Health Nutrition, University of Washington, Seattle, Washington 98195.
5
John S. McIlhenny Skeletal Muscle Physiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808.
6
Division of Molecular Genetics, Department of Pediatrics, Columbia University, New York, New York 10032.

Abstract

Obesity is among the most common and costly chronic disorders worldwide. Estimates suggest that in the United States obesity affects one-third of adults, accounts for up to one-third of total mortality, is concentrated among lower income groups, and increasingly affects children as well as adults. A lack of effective options for long-term weight reduction magnifies the enormity of this problem; individuals who successfully complete behavioral and dietary weight-loss programs eventually regain most of the lost weight. We included evidence from basic science, clinical, and epidemiological literature to assess current knowledge regarding mechanisms underlying excess body-fat accumulation, the biological defense of excess fat mass, and the tendency for lost weight to be regained. A major area of emphasis is the science of energy homeostasis, the biological process that maintains weight stability by actively matching energy intake to energy expenditure over time. Growing evidence suggests that obesity is a disorder of the energy homeostasis system, rather than simply arising from the passive accumulation of excess weight. We need to elucidate the mechanisms underlying this "upward setting" or "resetting" of the defended level of body-fat mass, whether inherited or acquired. The ongoing study of how genetic, developmental, and environmental forces affect the energy homeostasis system will help us better understand these mechanisms and are therefore a major focus of this statement. The scientific goal is to elucidate obesity pathogenesis so as to better inform treatment, public policy, advocacy, and awareness of obesity in ways that ultimately diminish its public health and economic consequences.

PMID:
28898979
PMCID:
PMC5546881
DOI:
10.1210/er.2017-00111
[Indexed for MEDLINE]
Free PMC Article

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