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Obesity is more than just a cosmetic concern. It's a complex and chronic disease that affects millions of people worldwide, increasing the risk of serious health problems such as heart disease, stroke, diabetes, and certain cancers. Despite efforts to combat obesity, it continues to be a major public health challenge. However, recognizing obesity as a disease, rather than a personal failing, is an important step towards finding effective treatments and improving overall health outcomes  


A thorough obesity assessment should aim to diagnose and identify the causes and consequences of abnormal or excess adiposity on a patient’s physical, mental and functional health.


While the advice to eat less and move more can be a helpful starting point for weight management, it may not be sufficient for individuals with obesity. A more personalized and comprehensive approach that addresses underlying factors is often necessary for successful weight loss and improved health outcomes. A complex interplay of genetic, metabolic, behavioral and environmental factors all contribute to the prevalence of obesity today.

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The Brain connection to Obesity

The cellular and molecular pathogenesis of obesity

Body weight is meticulously regulated for survival in unpredictable periods of feast and famine. Even a small surplus of caloric intake (less than 1%) over energy expenditure can accumulate over years to cause weight gain. 

The biological control of appetite is complex and involves the integration of the central neural circuits with signals from the gut, adipose tissue and other organs to influence homeostatic and hedonic eating, and the executive control by higher brain centres on the decision of when and what to eat. These neural networks have been shown to be altered in obesity

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The hypothalamus in the brain, has long been known to play a central role in energy homeostasis by regulating energy intake and expenditure.

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The Mesolimbic System

Hedonic eating is based on the feelings of reward and pleasure that are associated with seeing, smelling or eating food. This pathway means that the brain can crave food, or enjoy food, even when the person is completely satiated. Some people living with obesity may have a heightened anticipation (wanting) of the pleasure of food driven by a dysregulation of dopamine.

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Cognative Lobe

People living with obesity may have a dysfunctional connection between the cognitive lobe and the rest of the brain that leads to the inability to control eating behaviours

Genetics and Obesity


Many genes have been linked to the development of obesity, and more than 140 genetic regions are now known to influence obesity traits. 

The exact contribution of genetics to the development of obesity is still not fully understood, and estimates of the percentage of obesity that can be attributed to genetics vary widely depending on the study.

According to the National Institutes of Health, obesity is a complex disorder that is influenced by both genetic and environmental factors. While some studies have suggested that up to 70% of the risk of obesity may be related to genetic factors, other studies have found that genetics may account for as little as 25% of the risk.

It's important to note that even if genetics play a role in the development of obesity, lifestyle choices such as diet and physical activity still play a significant role in determining an individual's risk of developing the condition. Therefore, while genetic factors may contribute to the development of obesity, they are not the sole determinant and lifestyle interventions can still be effective in preventing or treating obesity.


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