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Scientific Statement

Endocrine Society issues Scientific Statement on obesity's causes

Despite decades of research and billions of dollars spent each year on treatment, understanding of the underlying causes of obesity remains limited

A Scientific Statement issued by the Endocrine Society has called for more research aimed specifically at understanding the underlying mechanisms that make it difficult to maintain long-term weight loss. Despite decades of research and billions of dollars spent each year on treatment, understanding of the underlying causes of obesity remains limited.

Growing evidence suggests obesity is a disorder of the body's intricate energy balance systems. Once an individual loses weight, the body typically reduces the amount of energy expended at rest, during exercise and daily activities while increasing hunger. This combination of lower energy expenditure and hunger creates a "perfect metabolic storm" of conditions for weight gain.

"Because of the body's energy balance adjustments, most individuals who successfully lose weight struggle to maintain weight loss over time," said Dr Michael W Schwartz, University of Washington in Seattle, WA, and the chair of the task force that authored the Society's Scientific Statement. "To effectively treat obesity, we need to better understand the mechanisms that cause this phenomenon, and to devise interventions that specifically address them. Our therapeutic focus has traditionally been on achieving weight reduction. Most patients can do this; what they have the most trouble with is keeping the weight off."

The Society's statement, 'Obesity Pathogenesis: An Endocrine Society Scientific Statement', published in Endocrine Reviews, also calls for additional research into factors influencing obesity;

  • Interactions between genetics, developmental influences and the environment
  • The effect of endocrine-disrupting chemicals such as bisphenol A on obesity
  • The microbiome, or bacteria in the gut, and its interactions with the endocrine and digestive systems as well as the brain
  • The reasons behind the therapeutic success of bariatric surgery
  • The role that diet composition plays in the development of obesity
  • Biological markers and predictors for diabetes, heart disease and other conditions that often develop in conjunction with obesity
  • The effects of socioeconomic status on obesity risk; and
  • Brain imaging to better understand appetite and feeding behaviour

“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,” the authors write.

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