The causes, prevalence, and treatment of obesity revisited in 2009: what have we learned so far?

Obesity is a chronic disease that is increasing in prevalence in the United States and worldwide and is often accompanied by multiple comorbidities that lead to type 2 diabetes and cardiovascular disease. In April 2009, the American Society for Nutrition hosted the symposium "An Integrative View of Obesity" at Experimental Biology 2009 in New Orleans, LA. The presentations addressed the causes of the obesity epidemic and notably discussed a combination of genetics, obesogenic environment, cultural and racial concerns, and treatment modalities based on what we have learned from research into the physiology and neuroendocrine regulation of appetite and satiety. The fat cell as an endocrine organ, in addition to contributions from the gut and pancreas, has helped us to understand the origins of this neuroendocrine regulation as a survival advantage in human ancestry, with obesogenic ramifications in today's toxic food environment. Suggestions for the reversal of the obesity epidemic were offered, including public health campaigns, community and medical programs, and industry-supported change in our food supply, eating patterns, and lifestyle. Community-structured programs for exercise and work-related physical activity could also engage a healthier lifestyle into the typical day for the average American as well as for individuals in other countries.