Pathophysiologie der Adipositas

Obesity is a chronic, progressive, incurable disease that is frequently characterized by relapse after short-term interventions. Through increased fat mass and adipose tissue dysfunction, obesity can contribute to multiple severe comorbidities. The fundamental cause of obesity is a long-term positive energy balance caused by too many calories consumed, too little physical activity and low energy expenditure. The pathophysiological origins of obesity are complex and include biological, societal, behavioral, environmental, economic and other factors and their interaction. Biological pathomechanisms of obesity development include inherited factors that modulate how the brain regulates appetite and satiety through complex and fine-tuned circuits in the hypothalamus. In addition, genetic factors may alter signals from adipose tissue, gut and other tissues that regulate periphery-to-brain crosstalk. Main society-related drivers of the worldwide increase in obesity prevalence are changes in global food markets, constant availability of energy dense nutrients that are rich in carbohydrates and fat paired with low demands for physical activity in private and working environments.