Decoding Adipose: A Journey to Understanding Obesity
Abstract
The adipose tissue, a metabolically active organ, plays a pivotal role in energy homeostasis, evolving to cope with the fluctuating availability of food. Obesity, characterized by excessive adipose tissue, is a chronic and heterogeneous disease adversely impacting health and longevity. It is intricately linked to the development of metabolic disorders such as type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular diseases, as well as various cancers and other chronic conditions. Despite its significance, direct measurement of adiposity is often impractical, leading to reliance on proxy measures like the body mass index (BMI). However, BMI has limitations, particularly in diverse populations like Asian Indians, who exhibit cardiovascular risk factors and diabetes at lower BMI levels compared to Caucasians. Moreover, fat distribution, particularly visceral adiposity, is a critical determinant of disease risk, with
waist circumference and waist-to-hip ratio serving as surrogate markers. Global obesity rates have surged over the past decades, exacerbated by obesogenic environments, sedentary lifestyles, and psycho-social factors. Childhood and adolescent obesity, in particular, have witnessed alarming increases. Moreover, individuals with obesity face pervasive bias and stigma, contributing to their elevated morbidity and mortality, independent of weight or BMI. These abstract underscores the multifaceted nature of obesity, its detrimental health implications, and the urgent need for comprehensive strategies to address its rising prevalence and associated health burdens.
References
2. Rahilly O, Farooqi IS, Loscalzo J, Fauci AS, Kasper DL, et al. Pathobiology of Obesity. In: Loscalzo J, Fauci AS, Kasper DL, et al., editors. Harrison’s Principles of Internal Medicine. 21st ed. New York: McGraw Hill Co; 2022. p. 3080-3086.
3. Wharton S, Lau DCW, Vallis M, Sharma M, et al. Obesity in Adults: A Clinical Practice Guidelines. CMAJ. 2020;192(31):E875-E891. DOI: https://doi.org/10.1503/cmaj.191707.
4. Shand AG, Lean MEJ, Penman ID, Ralston SH, Struchan MWJ, Hobson RP, et al., editors. Nutritional Factors in Disease. In: Penman ID, Ralston SH, Struchan MWJ, Hobson RP, editors.
Davidson’s Principles and Practice of Medicine. 24th ed. London: Elsevier Limited; 2023. p. 755-780.
5. Misra A, Chowbey P, Makkar BM, Vikram NK, et al. Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management. J Assoc Physicians India. 2009;57:163-170.
6. Shukla V, Deshpande AK, editors. Adipocytobiology in Type 2 Diabetes Mellitus. In: Deshpande AK, editor. Progress in Medicine. Vol 33. New Delhi: Jaypee Brothers Medical Publishers;
2023. p. 268-270.
7. Koenen M, Hill MA, Cohen P, Sowers JR. Obesity, Adipose Tissue and Vascular Dysfunction. Circ Res. 2021;128:951-968.
8. Madhu SV, Kapoor N, Das S, et al. ESI Clinical Practice Guideline of the Evaluation and Management of Obesity in India. Indian J Endocrinol Metab. 2022:295-318.
9. Kushner RF, Loscalzo J, Fauci AS, Kasper DL, et al. Evaluation and Management Of Obesity. In: Loscalzo J, Fauci AS, Kasper DL, et al., editors. Harrison’s Principles of Internal Medicine. 21st ed.New York: McGraw Hill Co; 2022. p. 3087-3094.
10. Goyal H, Kopel J, Perisetti A, Mann R, Ali A,Tharian B, et al. Endobariatric Procedures for Obesity: Clinical Indications and Available Options. Ther Adv Gastrointest Endosc. 2021;14:263177452098462.
11. Racette SB, Deusinger SS, Deusinger RH. Obesity: Overview of Prevalence, Etiology, and Treatment. Phys Ther. 2003;83(3):276-288.
