Is obesity associated with lower body temperatures? Core temperature: a forgotten variable in energy balance.

The global increase in obesity, along with the associated adverse health consequences, has heightened interest in the fundamental causes of excessive weight gain. Attributing obesity to "gluttony and sloth", blaming the obese for overeating and limiting physical activity, oversimplifies a complex problem, since substantial differences in metabolic efficiency between lean and obese have been decisively demonstrated. The underlying physiological basis for these differences have remained poorly understood. The energetic requirements of homeothermy, the maintenance of a constant core temperature in the face of widely divergent external temperatures, accounts for a major portion of daily energy expenditure. Changes in body temperature are associated with significant changes in metabolic rate. These facts raise the interesting possibility that differences in core temperature may play a role in the pathophysiology of obesity. This review explores the hypothesis that lower body temperatures contribute to the enhanced metabolic efficiency of the obese state.