While genetic influences are important to understanding obesity, they cannot explain the current dramatic increase seen within specific countries or globally. There is an indication that gut flora in obese and lean individuals can affect the metabolic potential. Management of obesity The main treatment for obesity consists of dieting and physical exercise. It has also changed significantly over time. Medical illnesses that increase obesity risk include several rare genetic syndromes listed above as well as some congenital or acquired conditions:
Sedentary lifestyle and Exercise trends A sedentary lifestyle plays a significant role in obesity. Management of obesity The main treatment for obesity consists of dieting and physical exercise. Social determinants of obesity The disease scroll Yamai no soshi, late 12th century depicts a woman moneylender with obesity, considered a disease of the rich. Gut bacteria See also: In particular, they and other appetite-related hormones act on the hypothalamus , a region of the brain central to the regulation of food intake and energy expenditure. Both groups of arcuate nucleus neurons are regulated in part by leptin. Pathophysiology of obesity There are many possible pathophysiological mechanisms involved in the development and maintenance of obesity. No significant differences were seen among men of different social classes. A review in found that in developed countries women of a high social class were less likely to be obese. The World Health Organization indicates people worldwide are taking up less active recreational pursuits, while a study from Finland  found an increase and a study from the United States found leisure-time physical activity has not changed significantly. The correlation between social class and BMI varies globally. Their ability to take advantage of rare periods of abundance by storing energy as fat would be advantageous during times of varying food availability, and individuals with greater adipose reserves would be more likely to survive famine. There are a number of theories as to the cause but most believe it is a combination of various factors. Those who quit smoking gain an average of 4. The decrease in strength of correlation was felt to be due to the effects of globalization. Obese people consistently under-report their food consumption as compared to people of normal weight. Whether these differences are the direct cause or the result of obesity has yet to be determined unequivocally. Most of this extra food energy came from an increase in carbohydrate consumption rather than fat consumption. The amount that these associations may have contributed to the rising rate of obesity is yet to be determined. There are several circuits within the hypothalamus that contribute to its role in integrating appetite, the melanocortin pathway being the most well understood. Solutions look at changing the factors that cause excess food energy consumption and inhibit physical activity. Thus a deficiency in leptin signaling, either via leptin deficiency or leptin resistance, leads to overfeeding and may account for some genetic and acquired forms of obesity. This apparent alteration of the metabolic potential is believed to confer a greater capacity to harvest energy contributing to obesity. This is a comprehensive evidence-based guideline to address the management and prevention of overweight and obesity in adults and children. In undeveloped countries the ability to afford food, high energy expenditure with physical labor, and cultural values favoring a larger body size are believed to contribute to the observed patterns. It is thought that in developed countries, the wealthy are able to afford more nutritious food, they are under greater social pressure to remain slim, and have more opportunities along with greater expectations for physical fitness. A correlation in BMI changes over time has been found among friends, siblings, and spouses.
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