Global Advanced Research Journal of Pharmacy and Pharmacology (GARJPP)
October 2013 Vol. 2(1), pp. 002-012
Copyright © 2013 Global Advanced Research Journals

Review

Pathophysiology of obesity: Focused, cause-driven approach to control the epidemic

Sunil Wimalawansa, MD, PhD, MBA, DSc

Cardio Metabolic Institute, 51 Veronica Avenue, Somerset, New Jersey, 08873, USA

E-mail: wimalawansa1@hotmail.com

Accepted 9 October, 2013

Abstract

Obesity is a disease with serious public health and economic outcomes.  It is more than simply a thermodynamic, genetic, or a metabolic problem of handling calories; it is a behavioral disorder and an inflammatory disease leading to dysregulation of metabolism and energy balance, and impairment of the neurohormonal systems, leading to accumulation of intra-abdominal fat leading to serious complications.  Obesity rates as indicated by the increasing body mass index (BMI) or by abdominal girth are escalating in the United States and most industrialized countries. Approximately two-thirds of these patients develop complications that would cost billions of taxpayer dollars.  However, in Asians BMI is less relevant and the increasing abdominal girth is a better indicator that reflect accumulation of the visceral fat; the most detrimental for the health.  Obesity is a multi-factorial disease for which genetics, environment, behavioral, physical and other factors contribute to the development.  Those who are obese and sick and unhealthy, secondary to accumulation of excessive visceral fat are at high risk of developing complications.  At the current rates, it is predicted that obesity-associated deaths are going to surpass cardiovascular deaths within the next two decades.  For the majority of overweight and obese people, it is necessary to reduce only seven to ten percent of their body weight via calorie-reduced diet and increasing physical activity that would improve the metabolism and decrease potential complications and premature deaths.  In addition to reasonable weight reduction programs, controlling the obesity-associated complications requires coordinated, cause-driven, and complication-centric approaches.  Understanding the cause for the obesity in each patient would greatly facilitate the development of an individualized, sustainable, and successful treatment plan.  Therefore, the multi-factorial nature of engender obesity needs a focused, specific, cause-driven approaches to combat.  Considering the high cost of managing obesity, type 2 diabetes and their complications, prevention of obesity is the way forward that is based on causes and risk factors.  This is one of the most cost-effective approaches to decrease the obesity-associated complications, morbidities and premature deaths.

Keywords: metabolism, epidemic, adepokines, body mass index (BMI), cardiovascular, morbidity, overweight.