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A paradigm shift for the prevention and treatment of individual and global obesity
Authors Slyper AH
Received 16 August 2018
Accepted for publication 10 October 2018
Published 29 November 2018 Volume 2018:11 Pages 855—861
DOI https://doi.org/10.2147/DMSO.S183777
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Juei-Tang Cheng
Video abstract presented by Arnold H Slyper.
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Arnold H Slyper
Clalit Health Organization, Jerusalem 9514622, Israel
Abstract: The prevalence of obesity and overweight has plateaued in developed countries, although at high levels, but in most parts of the world, it continues to increase. Current recommendations for preventing and treating obesity are based mainly on the notion that overeating results from hedonic eating as a result of unlimited access to palatable foods, particularly those high in sugar and fat, and that hedonic centers are able to “override” the body’s homeostatic mechanisms. This article proposes that the homeostatic mechanisms affecting appetite and satiety are more important in chronic overeating, and that sufficient evidence exists for adopting a new paradigm for controlling individual and global obesity based on controlling energy homeostasis via the enteroendocrine and gut microbiota systems. Many obese children and adolescents have chronic hunger, supporting the notion that they have a homeostatic rather than hedonic abnormality. The effectiveness of weight loss drugs and bariatric surgery suggests that the brain centers controlling energy homeostasis are able to override centers controlling hedonic drives. Energy homeostasis can also be influenced by nutrition, in particular, by avoiding sweetened drinks and consuming whole grains, vegetables, fruits and other foods that are high in dietary fiber, and thereby influence appetite and satiety. New recommendations are outlined for preventing and treating individual and global obesity based on a paradigm that targets appetite and satiety.
Keywords: obesity, appetite, satiety, nutrition
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