Aetiology of obesity: a striving after wind?

The current global epidemic of obesity is fuelled by a constant, unidirectional adverse effect on energy balance that exceeds the adaptive capacity of the system. The individual response to this environmental pressure is under the control of a variety of genes, which not only interacts with environmental factors but also with one another. Since the discovery that adipocytes may produce and secrete hormones, the adipose tissue has taken on increasing importance in the regulation of energy balance. Indeed, the pathogenesis of obesity, once regarded as so obvious and simple, is becoming one of the most complex in medical practice. From a clinical perspective, obesity is associated with a remarkably broad spectrum of health complications and, over the years, obesity-related mortality has consistently increased. From a theoretical viewpoint, the growing complexity of factors affecting the liability to obesity, the inconsistency of scientific results, the lack of consensus among scientists, and so forth, obstruct our efforts to unravel the aetiology of obesity. Is the field of obesity research merely a striving after wind, and nothing more?