Abstract

The development of obesity, or excess accumulation of adipose tissue, is a result of energy intake exceeding energy expenditure. Careful study of energy balance had provided insight into aetiologies of dynamic and mass-stable obesity, and important implications for the treatment of obesity and associated disorders. There is little evidence that hyperphagia is the major contributing factor in obesity. Recent studies have identified differences in energy expenditure in lean and obese subjects. Energy expenditure is the sum of the resting metabolic rate, thermic responses to food and exercise and facultative thermogenesis, and adaptive component sensitive to insulin and sympathetic nervous system activation. Treatment of obesity, including exercise and hypokilojoule dieting is viewed with relation to energy balance. Current models of reduced-obese and refractory-obese persons are considered with relation to the aetiologies of obesity and likely response to treatment. Verf.-Referat