University of Copenhagen, Novo Nordisk Foundation Centre for Basic Metabolic Research and Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark.
Philos Trans R Soc Lond B Biol Sci. 2023 Sep 11;378(1885):20220203. doi: 10.1098/rstb.2022.0203. Epub 2023 Jul 24.
Obesity in humans represents a cumulative retention of a tiny fraction of total energy intake as fat, which is accompanied by growth of the metabolically active, energy-demanding, lean body mass. Since the energy balance regulation operates irrespective of the excess fat storage, availability of the required energy supplies is a permissive condition for obesity development. It occurs predominantly among people genetically predisposed and/or living with social or mental challenges. I propose a theory in which the body responds to social disruptions as threats of a future lack of food by an adiposity force building a reserve of energy independent of the regulation of the energy balance. It is based on the assumption that our evolutionary development required collaboration in gathering and sharing of food, combined with precautionary measures against anticipated failing food supplies. Social challenges are perceived as such threats, which activate the adiposity force through the brain to instigate the growth of fat and lean mass by neuro-hormonal signalling. If both perceived social threats and food abundance continue, the adiposity force pushes the fat accretion process to continue without inhibition by feedback signals from the fat mass, eventually leading to more obesity, and more so among the genetically predisposed. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.
肥胖症代表着人体对总能量摄入的一小部分(即脂肪)的累积保留,同时伴随着代谢活跃、能量需求高、瘦体重的增长。由于能量平衡调节不受多余脂肪储存的影响,因此提供所需的能量供应是肥胖发展的许可条件。肥胖症主要发生在遗传易感性和/或存在社会或心理挑战的人群中。我提出了一种理论,即身体将社会干扰视为未来食物短缺的威胁,通过脂肪生成力来建立能量储备,而这种储备与能量平衡的调节无关。这一理论基于这样一种假设,即我们的进化发展需要在食物的收集和分享方面进行合作,同时采取预防措施来应对预期的食物供应不足。社会挑战被视为这种威胁,通过大脑中的神经激素信号激活脂肪生成力,促使脂肪和瘦体重的生长。如果感知到的社会威胁和食物丰度持续存在,脂肪生成力将推动脂肪积累过程继续进行,而不会受到来自脂肪组织的反馈信号的抑制,最终导致更多的肥胖症,而且在遗传易感性人群中更为明显。本文是讨论会议议题“肥胖症的成因:理论、推测和证据(第一部分)”的一部分。