'Obesities': Position statement on a complex disease entity with multifaceted drivers

Patricia Yárnoz-Esquiroz, Laura Olazarán, Maite Aguas-Ayesa, Carolina M Perdomo, Marta García-Goñi, Camilo Silva, José Antonio Fernández-Formoso, Javier Escalada, Fabrizio Montecucco, Piero Portincasa, Gema Frühbeck, Patricia Yárnoz-Esquiroz, Laura Olazarán, Maite Aguas-Ayesa, Carolina M Perdomo, Marta García-Goñi, Camilo Silva, José Antonio Fernández-Formoso, Javier Escalada, Fabrizio Montecucco, Piero Portincasa, Gema Frühbeck

Abstract

Academic medicine fosters research that moves from discovery to translation, at the same time as promoting education of the next generation of professionals. In the field of obesity, the supposed integration of knowledge, discovery and translation research to clinical care is being particularly hampered. The classification of obesity based on the body mass index does not account for several subtypes of obesity. The lack of a universally shared definition of "obesities" makes it impossible to establish the real burden of the different obesity phenotypes. The individual's genotype, adipotype, enterotype and microbiota interplays with macronutrient intake, appetite, metabolism and thermogenesis. Further investigations based on the concept of differently diagnosed "obesities" are required.

Keywords: Obesity phenotypes; Sarcopenic obesity; dysfunctional adipose tissue; metabolically healthy obesity; non-communicable diseases (NCDs); precision medicine.

Conflict of interest statement

The authors declare no conflicts of interest.

© 2022 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

Figures

FIGURE 1
FIGURE 1
Factors influencing energy homestasis. In the classical Venn diagram, the logical relation between factors shows that energy homeostasis is a balance between fat accumulation, food intake, nutrient absorption, energy expenditure, neuroendocrine control, genetics, epigenetics, environment and socio‐economic circumstances. Each factor can also influence single variables
FIGURE 2
FIGURE 2
Managing process to reach treatment goals. From a strategic point of view, in order to reach treatment goals, we recommend spending time for better understanding the problem, engaging healthcare professionals, identifying resources to sustain the process, defining diagnosis and disease management plan and then targeting the treatment goals

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Source: PubMed

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