Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL 32611-7011, USA.
Laboratory of Biological Modeling, Integrative Physiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA.
Philos Trans R Soc Lond B Biol Sci. 2023 Sep 11;378(1885):20220215. doi: 10.1098/rstb.2022.0215. Epub 2023 Jul 24.
The continued global increase in the prevalence of obesity prompted a meeting at the Royal Society of London investigating causal mechanisms of the disease, 'Causes of obesity: theories, conjectures, and evidence' in October 2022. Evidence presented indicates areas of obesity science where there have been advancements, including an increased understanding of biological and physiological processes of weight gain and maintenance, yet it is clear there is still debate on the relative contribution of plausible causes of the modern obesity epidemic. Consensus was reached that obesity is not a reflection of diminished willpower, but rather the confluence of multiple, complex factors. As such, addressing obesity requires multifactorial prevention and treatment strategies. The accumulated evidence suggests that a continued focus primarily on individual-level contributors will be suboptimal in promoting weight management at the population level. Here, we consider individual biological and physiological processes within the broader context of sociodemographic and sociocultural exposures as well as environmental changes to optimize research priorities and public health efforts. This requires a consideration of a systems-level approach that efficiently addresses both systemic and group-specific environmental determinants, including psychosocial factors, that often serve as a barrier to otherwise efficacious prevention and treatment options. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.
肥胖症在全球范围内的持续流行促使人们在 2022 年 10 月于伦敦皇家学会召开了一次会议，会议主题为“肥胖症的病因：理论、推测和证据”，旨在调查该疾病的病因机制。会上提出的证据表明，肥胖症科学领域已经取得了一些进展，包括对体重增加和维持的生物学和生理学过程有了更深入的了解，但显然对于现代肥胖症流行的各种可能病因的相对贡献仍存在争议。会议达成共识，肥胖症并非意志力减弱的表现，而是多种复杂因素共同作用的结果。因此，解决肥胖问题需要采取多因素预防和治疗策略。现有证据表明，继续主要关注个体层面的因素，对于促进人群层面的体重管理来说并不是最佳选择。在这里，我们在更广泛的社会人口学和社会文化暴露以及环境变化背景下，考虑个体的生物学和生理学过程，以优化研究重点和公共卫生工作。这需要考虑一种系统层面的方法，该方法能够有效地解决系统性和特定于群体的环境决定因素，包括心理社会因素，这些因素通常是有效预防和治疗措施的障碍。本文是“肥胖症的病因：理论、推测和证据（第一部分）”讨论会议的一部分。
