Obesity is often described as an imbalance between caloric intake and energy expenditure. This simplified view has led some to suggest that obesity is the fault of the obese person due to excessive consumption, inadequate activity, or a combination of the two, resulting in much of the stigma that is associated with this condition. While decreased caloric consumption and increased physical activity can be effective in normalizing weight, these lifestyle modifications have proven very difficult to sustain. The failure of many lifestyle modifications to reduce obesity over the long term suggests that obesity might not be entirely a metabolic disorder, but likely has a neuropsychogenic component. While food addiction certainly does not explain all cases of obesity, the prevalence of people who eat for reasons other than obtaining energy suggests it may be time to consider new ways of understanding and approaching this problem. Given that some of the cultural factors discussed previously are driven by economic factors that lie outside the control of the individual, the topic of obesity cannot simply be relagated to the domain of personal responsibility. References:
- Volkow ND, O’Brien CP. Issues for DSM-V: should obesity be included as a brain disorder? Am J Psychiatry. May 2007; 164(5), 708-710.
- Volkow ND, Wang GL, Baler RD. Reward, dopamine and the control of food intake: implications for obesity. Trends Cogn Sci. Jan 2011; 15(1), 37-46.
