Current paradigms in the etiology of obesity

The global prevalence of obesity continues to rise at an alarming rate and 37.7% of US adults are obese. Understanding the causes of excessive weight gain is extremely important, as it paves the way for the development of new therapies to control this epidemic. Obesity is a heterogeneous chronic disease where multiple factors interact to produce a state of positive energy balance leading to an increase in body weight. This review focuses on the major biological, environmental, and behavioral determinants of obesity. The key biological factors include genetics, brain-gut axis, prenatal determinants, pregnancy, menopause, neuroendocrine conditions, medications, physical disability, gut microbiome, and viruses. Propensity to develop obesity owing to one or more of these elements is exacerbated by environmental and behavioral influences. Environmental factors include food abundance, built environments, socioeconomic status, culture, social bias, and environmental chemicals. Behavioral factors comprise excessive calorie intake, eating patterns, sedentary lifestyles, insufficient sleep, and smoking cessation. It is essential to identify the determinants of adiposity in individuals with obesity to tailor prevention and treatment techniques effectively.