Treatment of obesity: should we target the individual or society?

Obesity is a heritable disease that affects millions of people, is disproportionately prevalent in some ethnic groups, and has serious health consequences. Molecular mechanisms causing excessive adiposity are being discovered at an unprecedented rate in animal models. The same cannot be said for humans and, in fact, the etiology of obesity in the majority of people remains unknown. Furthermore, we are far from fully understanding how an obesogenic environment increases the severity of the disease in people who are genetically susceptible to weight gain. Due to these uncertainties, it is perhaps not surprising that current antiobesity treatments are moderately effective at best. This manuscript provides a brief review of current and future strategies for the treatment of obesity and how they relate to our current knowledge of its pathophysiology. It is concluded that there are reasons to be moderately optimistic that effective pharmacological means to palliate obesity will eventually be identified. However, reversing the current pandemic will require a greater understanding not only of the molecular and physiological underpinnings, but also social and political causes of this disease.