Obesity is a disease. It was once not considered to be a disease and to be a matter of will power and gluttony. It was also the case that we once thought that fat tissue had no metabolic function other than to be inert and store fat. We now know that adipose tissue is an endocrine organ that secretes adipokines that regulate metabolism and energy balance. There are several kinds of adipose tissue: white brown and beige. We used to think that brown fat was not present in adult humans, only in animals and human babies to generate heat. We now know that brown fat exists in the adult human and that white fat can undergo browning to become beige fat and burn more calories. We used to think that people who lost weight and regained it back and more had psychological disorders that made them eat. The overwhelming reason for weight regain is the body readjusting the energy regulation system and adjusting hormone levels so that a person feels preoccupied with food until they regain the weight. Other adjustments are made to resting metabolic rate so that it decreases to facilitate regain of weight. There is also some evidence to suggest that it may be our food supply that is creating this increase in the prevalence of obesity by interacting with pathways to appetite and satiety in the brain, thereby altering the signals to appetite and satiety. Foods high in fat cause obesity in animal models also cause inflammation in the hypothalamic area that controls food intake. These animals no longer regulate body fat and gain weight and eventually defend a high body set point weight. Human physiology may go through this same mechanism to defend a higher body weight in this toxic food environment.
How can we combat this new disease? Drugs devices and surgery and new methods in the pipeline are considered.