ESPE Yearbook of Paediatric Endocrinology

Brief Summary: This review describes how views and understanding of obesity have changed over the last 100 years and how new therapies have been developed. The article summarizes key milestones in knowledge gains that led to the science community’s current understanding. It also shows how the scientific world has dealt with this gain in knowledge in terms of the activity of professional societies and scientific publications. The review closes with a few important aphorisms about obesity learned over the past.

The author Dr George Bray has dedicated his professional life to the research in obesity and metabolism. He has gained international recognition for his pioneering research on both the experimental and clinical levels. With his perspective and personal scientific experience over more than 60 years, he is one of the few people who can reflect the historical development to a large extent as a witness.

The assessment of obesity with regard to its development depended on the available scientific methods. The evaluation of large epidemiological data sets in combination with genetic analyses impressively demonstrated the strong dependence of body fat mass on genetic predisposition and the living environment. The study of rare syndromic obesity forms in mice and humans have paved the way for the definition of subtypes and the development of effective pharmacological treatments. Mythical beginnings, errors and corrections in the understanding of energy metabolism and the resulting attempts at intervention have led to today’s recognition of obesity as a chronic relapsing progressive disease characterized by an inflammatory state and associated with significant mortality and morbidity (1). There is still a long way to go for these findings to save affected patients from painful odysseys and to dispel the obesity stigma in society (2).

References: 1. Bray GA, Kim KK, Wilding JPH; World Obesity Federation. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017 Jul;18(7):715-723. doi:10.1111/obr.12551. Epub 2017 May 10. PMID: 28489290.2. Rubino F, Puhl RM, Cummings DE, Eckel RH, Ryan DH, Mechanick JI, Nadglowski J, Ramos Salas X, Schauer PR, Twenefour D, Apovian CM, Aronne LJ, Batterham RL, Berthoud HR, Boza C, Busetto L, Dicker D, De Groot M, Eisenberg D, Flint SW, Huang TT, Kaplan LM, Kirwan JP, Korner J, Kyle TK, Laferrère B, le Roux CW, McIver L, Mingrone G, Nece P, Reid TJ, Rogers AM, Rosenbaum M, Seeley RJ, Torres AJ, Dixon JB. Joint international consensus statement for ending stigma of obesity. Nat Med. 2020 Apr;26(4):485-497. doi:10.1038/s41591-020-0803-x. Epub 2020 Mar 4. PMID: 32127716; PMCID: PMC7154011.