Obesity: regulation of appetite and energy homeostasis; treatment

Big picture

Obesity is a chronic, relapsing metabolic disease caused by long-term imbalance between energy intake, energy expenditure, appetite regulation, genetic susceptibility, environment, and neuroendocrine adaptation.

For the exam, do not explain obesity only as “eating too much.” The high-yield concept is:

Brain appetite centers + gut hormones + adipose hormones + reward system
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Control hunger, satiety, energy expenditure, and body-weight set point
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In obesity: leptin resistance, insulin resistance, hedonic overeating, low energy expenditure, adaptive metabolic slowing
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Weight gain becomes biologically defended

Treatment is stepwis