Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation
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Summary: This paper considers the argument for obesity as a chronic relapsing disease process. Obesity is viewed from an epidemiological model, with an agent affecting the host and producing disease. Food is the primary agent, particularly foods that are high in energy density such as fat, or in sugar‐sweetened beverages. An abundance of food, low physical activity and several other environmental factors interact with the genetic susceptibility of the host to produce positive energy balance. The majority of this excess energy is stored as fat in enlarged, and often more numerous fat cells, but some lipid may infiltrate other organs such as the liver (ectopic fat). The enlarged fat cells and ectopic fat produce and secrete a variety of metabolic, hormonal and inflammatory products that produce damage in organs such as the arteries, heart, liver, muscle and pancreas. The magnitude of the obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environment and its interaction with the host. Thus, obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is food rather than a microbe. Reversing obesity will prevent most of its detrimental effects.
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The causes of obesity are multifactorial and incompletely understood.
“The causes of obesity are multifactorial and incompletely understood.2,5,80”
From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [5]
The agent and Genetic factors sections describe multiple environmental and genetic contributors to obesity, supporting ‘multifactorial.’ Our copy does not say that obesity’s causes are incompletely understood, so that part of the claim is not supported. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe obesogenic environment continues to fuel the obesity pandemic on a population level in the USA and other nations.
“the obesogenic environment that continues to fuel this pandemic on a population level in the USA and other nations [121]”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [121]
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Obesity: pathophysiology and therapeutic interventions
Kong, Y., Yang, H., Nie, R., Zhang, X., Zuo, F., Zhang, H., & Nian, X. (2025) · Molecular Biomedicine · doi:10.1186/s43556-025-00264-9 · Cited by 89 · see citing works
Effects of ingested nanocellulose on intestinal microbiota and homeostasis in Wistar Han rats
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The Role of Exercise, Diet, and Cytokines in Preventing Obesity and Improving Adipose Tissue
ATAKAN, M. M., Koşar, Ş. N., Güzel, Y., Tin, H. T., & Yan, X. (2021) · Nutrients · doi:10.3390/nu13051459 · Cited by 94 · see citing works
Pontes, K. S. D. S., Guedes, M. R., Cunha, M. R. D., Mattos, S. D. S., Barreto Silva, M. I., Neves, M. F., Marques, B. C. A. A., & Klein, M. R. S. T. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.06.023 · Cited by 86 · see citing works
Perceptions of barriers to effective obesity management in Canada: Results from the ACTION study
Sharma, A. M., Bélanger, A., Carson, V., Krah, J., Langlois, M., Lawlor, D., Lepage, S., Liu, A., Macklin, D. A., MacKay, N., et al. (2019) · Clinical Obesity · doi:10.1111/cob.12329 · Cited by 86 · see citing works
The economic burden of obesity in Italy: a cost-of-illness study
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Multifactorial Basis and Therapeutic Strategies in Metabolism-Related Diseases
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Addressing weight bias and discrimination: moving beyond raising awareness to creating change
Salas, X. R., Alberga, A. S., Cameron, E., Estey, L., Forhan, M. A., Kirk, S., Russell‐Mayhew, S., & Sharma, A. M. (2017) · Obesity Reviews · doi:10.1111/obr.12592 · Cited by 83 · see citing works
- Authors
- Bray, G. A., Kim, K. K., Wilding, J. P. H., & on behalf of the World Obesity Federation
- Affiliations
- Pennington Biomedical Research Center (US)
- National University of Korea Seoul Korea
- University of Liverpool (GB)
- Corresponding author
- Bray, G.A.
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2017-05-10
- Volume
- 18
- Issue
- 7
- Pages
- 715-723
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2612234120
- Cited by
- 1,612
- References
- 91
- Citations by year
- 2026: 210 · 2025: 242 · 2024: 243 · 2023: 217 · 2022: 191 · 2021: 202 · 2020: 135 · 2019: 107 · 2018: 48 · 2017: 15 · 2013: 1
- FWCI
- 78.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- obesity, chronic relapsing disease, disease models, energy balance, energy-dense foods, sugar-sweetened beverages, physical inactivity, genetic susceptibility, adipose tissue, ectopic fat, liver fat, metabolic inflammation, host-environment interactions, obesity reversal
- MeSH terms
- Chronic Disease, Diet, Dietary Carbohydrates, Dietary Fats, Environment, Food, Humans, Obesity, Recurrence, Weight Gain, Exercise
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