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Obesity Much More Complex than Energy Intake/Output Balance, Doctor Writes

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SOURCE Association of American Physicians and Surgeons (AAPS)

TUCSON, Ariz., June 12, 2014 /PRNewswire-USNewswire/ -- Despite tons of research and constant anti-obesity campaigns, obesity is increasing, and its cause is not understood, writes neuroendocrinologist Hermann Borg, M.D., in the summer issue of the Journal of American Physicians and Surgeons.

It's more than the simplistic balance of energy input and output, Dr. Borg explains. More complex concepts such as the "adipostat" and "slow metabolism," however, have not been helpful. Genetics plays a role, but is not the whole story. Diet and exercise are clearly important, but there is a long string of highly touted interventions that fail in the long run, including diets from Atkins to the Zone and exercise "boot camps."

While morbid obesity is clearly lethal, leaner is not always healthier, Borg states.

Bariatric surgery has impressive results as compared with any other available method of weight control, Borg observes. "It has been demonstrated that observed weight reduction and metabolic changes that follow bariatric surgery cannot be explained simply by decreasing the absorptive surface of the gut, or speeding up transit." But what does account for the results?

Borg discusses the role of gut hormones, gut bacteria, and endocannabinoids. Medical manipulations might, it is hoped, make it possible to obtain good results without the risks of surgery. But the systems are extremely complex, and the body's mechanisms for keeping them in balance are not completely understood.

Until safe, effective methods of weight control are developed based on knowledge of the body's homeostatic systems, patients and doctors are in the "obesity quagmire," Borg writes. They need to be aware of the limitations of current therapies.

The Journal is the official, peer-reviewed publication of the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties, founded in 1943 to preserve private medicine and the patient-physician relationship.

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