Obesity

About the Author and Illustrator viii

Preface x

Acknowledgements xi

1 Obesity: A Global Health Problem 1

The Definition of Obesity: What Is It? 3

The Origin of Obesity: What Has Caused the Global Obesity Problem? 7

The Stigmatisation of Obesity 11

References 14

2 Appetite 16

The Neurobiology of Appetite 17

What Controls the Appetite Dimmer Switches? 20

How Our Genes Influence Our Appetite and BMI? 22

Whose Appetite Is It Anyway? 24

Appetite as Body Weight Conservator 25

References 27

3 Body Mass Index 28

Body Composition 31

Body Fat Distribution 35

References 37

4 Muscle and Metabolism 39

Metabolism 42

Cannon to the Right of Them, Cannon to the Left of Them 44

The Best Defence Is a Good Offense 49

References 52

5 The Gut Microbiota 55

The Origins of the Gut Microbiota 58

Listening in on Conversations Between the Gut Microbiota and Brain 59

Strategies to Optimise Our Gut Microbiota to Promote Our Health and Well-Being 64

References 68

6 Sleep as a Pillar of Health 70

The Negative Impact of Our Modern-Day Obesogenic Environment on Our Sleep 71

Mechanisms That Link Our Sleep with the Control of Appetite and Metabolism 73

Strategies to Optimise Our Sleep Duration, Quality and Pattern 74

References 81

7 Physical Exercise 82

Physical Activity and Metabolic Rate 83

The Truth About Sedentariness 86

The Metabolic Benefits of Physical Activity 87

How to Optimise Our Physical Activity 91

References 94

8 Fibre: A Forgotten Dietary Macronutrient 95

Dietary Fibre: What Is It? 96

Dietary Fibre: Why All the Fuss? 97

Dietary Fibre: The Health Benefits 97

Dietary Fibre: How Does It Work? 101

Dietary Fibre: How to Optimise Our Intake? 102

References 105

9 Listening 107

References 114

10 Pharmacotherapies and the Future of Obesity Management 116

In the Beginning, There Was the 'Incretin Effect' 117

The Physiology of GLP1 119

Therapeutic Rationale and the Early Days of GLP1-Based Therapies 121

The Modern Era of GLP1-Based Therapies 123

What Are the Safety Concerns with GLP1 Therapies? 124

What Are the Tolerability Concerns of GLP1 Therapies? 125

How Much Weight Loss Will I Achieve with a GLP1 Therapy? 125

How Long Can I Take a GLP1 Therapy for? 126

What Happens to My Weight When I Stop a GLP1 Therapy? 127

How Does a GLP1 Therapy Help Me to Lose Weight? 127

Beyond Weight Loss, Are There Other Health Benefits of Taking a GLP1 Therapy? 128

The Future of Obesity Management 128

References 133

11 Which Diet? Why No Size Fits All 134

Distraction and Discombobulation 135

It Is Time to Take a Chill-Pill 139

It Ain't Just the Food, It's the Way That You Eat It 141

When in Rome 142

Healthy Diet Versus 'Negative Energy Balance' (NEB) 142

Whose Diet Is It Anyway? 144

References 145

12 Our Future Transition from Obesogenic to Leptogenic Environment 146

Our Obesogenic Environment 147

Physical 147

Food 150

Cultural 152

A Model for a Future Leptogenic Environment 153

Epilogue 157

References 160

Index 161