Monitoring of stored and available fuel by the CNS: Implications for obesity

  • Seeley R
  • Woods S
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REVIEWS Eating encompasses a complex series of behaviours that are influenced by various environmental and biological factors. The history of biology and neuroscience includes numerous attempts to understand the neural underpinnings of eating, and these attempts have taken on an unfortunate urgency over the last decade owing to the exponential increase in obesity in both the devel-oped and developing world. The Surgeon General of the United States estimates that more than 300,000 deaths in the United States each year can be attributed to the effects of obesity (compared with the estimated 400,000 deaths that are attributable to tobacco) 1 . It is particularly troubling that children are not being spared by this epidemic — 15.5% of children aged from 12 to 19 are now considered to be obese, a rise of 50% in just the last 10 years 2 . The human and monetary costs of obesity will continue to rise unless effective preventive and/or therapeutic strategies can be developed. Although our growing waistlines might indicate otherwise, the system that matches caloric intake to caloric expenditure is remarkably accurate. A typical male human consumes approximately 900,000 calories per year. To gain just one extra pound per year requires him to eat approximately 4000 calories more than are burned in that year (or just 11 calories per day). So, a gain of one pound per year reflects an error of less than 0.5 percent. In fact, the average yearly increase of weight in the U.S. population is less than one pound per adult. However, it should be stressed that this statistic does not take into account the considerable variability between individuals, and environmental and genetic factors both contribute to susceptibility to weight gain. There are two stories to tell about how the body weight regulatory system relates to the crisis of obesity. The first focuses on the small, cumulative inaccuracies of the system, which result in gradual weight gain in some individuals. Considerable controversy surrounds this topic, with disagreements about the dietary and envi-ronmental contributions that have brought us to this situation. Clearly, something about our lives has changed over the last 50 years that has resulted in the increasing prevalence of obesity, and identifying these factors and understanding how they alter the regulatory system is an area of intense investigation 3–5

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